Provider Demographics
NPI:1932680964
Name:DADKHAH, ARMON SHAWN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ARMON
Middle Name:SHAWN
Last Name:DADKHAH
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 1:7304 ALBERT ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4282
Mailing Address - Country:US
Mailing Address - Phone:912-532-0894
Mailing Address - Fax:
Practice Address - Street 1:700 E DERENNE AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6716
Practice Address - Country:US
Practice Address - Phone:912-354-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH030891OtherGA RPH LICENSE