Healthcare Provider Details

I. General information

NPI: 1821297268
Provider Name (Legal Business Name): AMIR EMAMIFAR PHARMD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 06/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

1364 CLIFTON RD NE
ATLANTA GA
30322-1059
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-7150
  • Fax: 404-712-0868
Mailing address:
  • Phone: 404-712-7150
  • Fax: 404-712-0868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH023031
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29507
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: