MEDICARE: MR. CHRISTOPHER JASKOWIAK RPH

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
1	183500000X	Pharmacist	RPH021585	GA

General Provider Information

NPI Number	:	1851698252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER JASKOWIAK RPH

Provider Business Mailing Address
First Line	:	1276 DIAMOND AVE SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-3420
Country	:	US
Telephone Number	:	404-542-9306
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 PIEDMONT AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5044
Country	:	US
Telephone Number	:	404-876-2263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2011
Last Update Date	:	02/21/2011

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