Healthcare Provider Details

I. General information

NPI: 1104331958
Provider Name (Legal Business Name): JORGE KARBIR CESPEDES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2017
Last Update Date: 12/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 PEACHTREE RD NE
ATLANTA GA
30326-1039
US

IV. Provider business mailing address

6851 ROSWELL RD APT D20
ATLANTA GA
30328-2458
US

V. Phone/Fax

Practice location:
  • Phone: 866-787-6341
  • Fax:
Mailing address:
  • Phone: 305-987-1669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH028673
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: