Provider Demographics
NPI:1619962370
Name:SANTA, ELIZABETH KATSACOS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:KATSACOS
Last Name:SANTA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7615 BRIGHAM DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-5619
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:404-728-4715
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-728-4715
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37658183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist