Healthcare Provider Details

I. General information

NPI: 1356426977
Provider Name (Legal Business Name): JULI BETTANDORFF ESCHENBACH PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 HOWELL MILL RD NW SUITE 326
ATLANTA GA
30327-4111
US

IV. Provider business mailing address

1009 SMOKETREE DR
TUCKER GA
30084-1550
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-3788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH022642
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: