Healthcare Provider Details

I. General information

NPI: 1427963552
Provider Name (Legal Business Name): RYAN SARVESTANI PHARMD, MS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

1005 HIGHLAND LAKE CIR
DECATUR GA
30033-3456
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH036380
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: