Provider Demographics
NPI:1851560908
Name:SLUTSKY, ALAN MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:MICHAEL
Last Name:SLUTSKY
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 1:1591 GEORGIA HIGHWAY 20 NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-3834
Mailing Address - Country:US
Mailing Address - Phone:678-413-2471
Mailing Address - Fax:678-413-2476
Practice Address - Street 1:1591 GEORGIA HIGHWAY 20 NE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3834
Practice Address - Country:US
Practice Address - Phone:678-413-2471
Practice Address - Fax:678-413-2476
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH011726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist