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NPI Code Detail

MEDICARE: DR. ELIZABETH KATSACOS SANTA PHARM.D.

MEDICARE: DR. ELIZABETH KATSACOS SANTA PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS37658FL
21835P1200XPharmacotherapy PharmacistPS37658FL

General Provider Information

NPI Number : 1619962370
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH KATSACOS SANTA PHARM.D.
Provider Business Mailing Address
First Line : 7615 BRIGHAM DR
Second Line :
City : ATLANTA
State : GA
Zip : 30350-5619
Country : US
Telephone Number : 404-321-6111
Fax Number : 404-728-4715
Provider Business Practice Location Address
First Line : 1670 CLAIRMONT RD
Second Line :
City : DECATUR
State : GA
Zip : 30033-4004
Country : US
Telephone Number : 404-321-6111
Fax Number : 404-728-4715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2005
Last Update Date : 04/28/2016

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