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General NPI Number Information
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NPI Number | 1013737634
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Entity Type | Individual
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Provider Name | AVINASH SUKHU PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 4183 HIGHWAY 278 NE
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City | COVINGTON
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State | GA
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Zip | 30014-2400
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Country | US
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Telephone | 770-788-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 4192 SALEM RD
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City | COVINGTON
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State | GA
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Zip | 30016-4532
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Country | US
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Telephone | 770-788-2026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH035226
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License Number State | GA
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