Provider Demographics
NPI:1952324147
Name:BACARDI, JOSEFINA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JOSEFINA
Middle Name:
Last Name:BACARDI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5465 PRESERVE CIR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8907
Mailing Address - Country:US
Mailing Address - Phone:770-667-6056
Mailing Address - Fax:
Practice Address - Street 1:199 HILDERBRAND DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3855
Practice Address - Country:US
Practice Address - Phone:404-781-1800
Practice Address - Fax:404-781-1807
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA-018258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist