Healthcare Provider Details

I. General information

NPI: 1114224466
Provider Name (Legal Business Name): KHUSHBU AMIN PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KHUSHBU AMIN PHARM D

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2744 WASHINGTON RD
AUGUSTA GA
30909-2218
US

IV. Provider business mailing address

2744 WASHINGTON RD
AUGUSTA GA
30909-2218
US

V. Phone/Fax

Practice location:
  • Phone: 706-733-4277
  • Fax:
Mailing address:
  • Phone: 954-604-9224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH024759
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberSC12704
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: