Provider Demographics
NPI:1629669163
Name:OHAYA, JUDE C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JUDE
Middle Name:C
Last Name:OHAYA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 FOREST PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-2165
Mailing Address - Country:US
Mailing Address - Phone:404-366-9088
Mailing Address - Fax:404-366-8982
Practice Address - Street 1:381 FOREST PKWY STE A
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-2165
Practice Address - Country:US
Practice Address - Phone:404-366-9088
Practice Address - Fax:404-366-8982
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist