Healthcare Provider Details

I. General information

NPI: 1093449738
Provider Name (Legal Business Name): ANAS DAMIRI I PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TECHNOLOGY CT SE STE B
SMYRNA GA
30082-5201
US

IV. Provider business mailing address

200 TECHNOLOGY CT SE STE B
SMYRNA GA
30082-5201
US

V. Phone/Fax

Practice location:
  • Phone: 678-981-7029
  • Fax:
Mailing address:
  • Phone: 865-789-0089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH034046
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: