Healthcare Provider Details

I. General information

NPI: 1497176424
Provider Name (Legal Business Name): PATRICK TU PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2013
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 NATHAN DEAN BLVD
DALLAS GA
30132-4911
US

IV. Provider business mailing address

4361 WALFORDE BLVD
ACWORTH GA
30101-6391
US

V. Phone/Fax

Practice location:
  • Phone: 770-443-8776
  • Fax:
Mailing address:
  • Phone: 404-247-9635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH027232
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH027232
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: