Provider Demographics
NPI:1528605417
Name:JUGGASSAR, ALEX JOEY
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:JOEY
Last Name:JUGGASSAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 PEACHTREE CENTER AVE NE STE 600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1277
Mailing Address - Country:US
Mailing Address - Phone:833-215-1137
Mailing Address - Fax:833-537-3348
Practice Address - Street 1:303 PEACHTREE CENTER AVE NE STE 600
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1277
Practice Address - Country:US
Practice Address - Phone:833-215-1137
Practice Address - Fax:833-537-3348
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027838183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist