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NPI Code Detail

MEDICARE: MR. KAMRAN MORADI PHARMD.

MEDICARE: MR. KAMRAN MORADI PHARMD.
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
1183500000XPharmacistRPH022368GA

General Provider Information

NPI Number : 1689041980
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KAMRAN MORADI PHARMD.
Provider Business Mailing Address
First Line : 1600 TOWNE LAKE PKWY
Second Line :
City : WOODSTOCK
State : GA
Zip : 30189-1585
Country : US
Telephone Number : 770-517-1022
Fax Number : 678-445-3391
Provider Business Practice Location Address
First Line : 1600 TOWNE LAKE PKWY
Second Line :
City : WOODSTOCK
State : GA
Zip : 30189-1585
Country : US
Telephone Number : 770-517-1022
Fax Number : 678-445-3391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2015
Last Update Date : 08/21/2015

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