Provider Demographics
NPI:1558739029
Name:SINOJIARX1
Entity Type:Organization
Organization Name:SINOJIARX1
Other - Org Name:BRASELTON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:K
Authorized Official - Last Name:SINOJIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-327-8650
Mailing Address - Street 1:3841 ROXFIELD DR
Mailing Address - Street 2:BUFORD
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8507
Mailing Address - Country:US
Mailing Address - Phone:678-327-8650
Mailing Address - Fax:
Practice Address - Street 1:5745 OLD WINDER HWY
Practice Address - Street 2:SUITE - G
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-1636
Practice Address - Country:US
Practice Address - Phone:678-327-8650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy