Healthcare Provider Details

I. General information

NPI: 1982769311
Provider Name (Legal Business Name): CHRISTIANS PHARMACY & HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 06/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4980 PHILLIPS DR
FOREST PARK GA
30297-1472
US

IV. Provider business mailing address

4980 PHILLIPS DR
FOREST PARK GA
30297-1472
US

V. Phone/Fax

Practice location:
  • Phone: 404-362-2990
  • Fax: 404-362-2994
Mailing address:
  • Phone: 404-362-2990
  • Fax: 404-362-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHHH000012
License Number StateGA

VIII. Authorized Official

Name: JOHN CHAFIN
Title or Position: OWNER
Credential: PHARMD
Phone: 404-362-6901