Healthcare Provider Details

I. General information

NPI: 1841109063
Provider Name (Legal Business Name): JAPHET N OBI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 E POINT ST
EAST POINT GA
30344-4201
US

IV. Provider business mailing address

331 STILLWOOD CT
JONESBORO GA
30238-5867
US

V. Phone/Fax

Practice location:
  • Phone: 404-748-6028
  • Fax: 404-868-4202
Mailing address:
  • Phone: 678-923-8667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH015959
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: