Healthcare Provider Details

I. General information

NPI: 1427045376
Provider Name (Legal Business Name): MELISSA FRANCES SANACORE PHARMD, BCOP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FERRY RD NE NORTHSIDE HOSPITAL - DEPARTMENT OF PHARMACY
ATLANTA GA
30342-1606
US

IV. Provider business mailing address

3820 ADAMS RD
CUMMING GA
30041-4650
US

V. Phone/Fax

Practice location:
  • Phone: 404-845-5604
  • Fax:
Mailing address:
  • Phone: 770-263-9514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberRPH019379
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: