Healthcare Provider Details

I. General information

NPI: 1982259883
Provider Name (Legal Business Name): KARA FIFER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA ASSELBORN

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 JESSE HILL JR DR SE
ATLANTA GA
30303-3031
US

IV. Provider business mailing address

1824 DEFOOR AVE NW APT 4106
ATLANTA GA
30318-3061
US

V. Phone/Fax

Practice location:
  • Phone: 815-582-7786
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS023281
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051301991
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH031326
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: