Provider Demographics
NPI:1619258092
Name:ARSHAD, KAMAAL FAHEEM (RPH)
Entity Type:Individual
Prefix:
First Name:KAMAAL
Middle Name:FAHEEM
Last Name:ARSHAD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3979 PARHAM WAY
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1592
Mailing Address - Country:US
Mailing Address - Phone:404-593-6337
Mailing Address - Fax:678-945-1973
Practice Address - Street 1:590 THORNTON RD
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-1574
Practice Address - Country:US
Practice Address - Phone:678-945-1640
Practice Address - Fax:678-945-1973
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020640183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist