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General NPI Number Information
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NPI Number | 1073853933
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Entity Type | Individual
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Provider Name | TAREK JOHN KERBAGE RPH
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Gender | Male
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 01/21/2017
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Provider Practice Location Address
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Address Line | 199 HABERSHAM COUNTY SHOPPING CTR
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City | CORNELIA
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State | GA
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Zip | 30531-3412
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Country | US
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Telephone | 706-778-8099
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Fax | 706-778-8100
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Provider Business Mailing Address
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Address Line | 199 HABERSHAM COUNTY SHOPPING CTR
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City | CORNELIA
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State | GA
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Zip | 30531-3412
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Country | US
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Telephone | 706-778-8099
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Fax | 706-778-8100
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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 | PS34598
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH028237
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License Number State | GA
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