Healthcare Provider Details

I. General information

NPI: 1508477522
Provider Name (Legal Business Name): WHITNEY TESTORF PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 08/13/2020
Certification Date: 08/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1874 PIEDMONT AVE NE STE 100A
ATLANTA GA
30324-4816
US

IV. Provider business mailing address

1874 PIEDMONT AVE NE STE 100A
ATLANTA GA
30324-4816
US

V. Phone/Fax

Practice location:
  • Phone: 404-733-6800
  • Fax:
Mailing address:
  • Phone: 404-733-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH030923
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: