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General NPI Number Information
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NPI Number | 1386231017
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Entity Type | Individual
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Provider Name | SARA ROHANI TAZANGI
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Gender | Female
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 546 BANKHEAD HWY
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City | CARROLLTON
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State | GA
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Zip | 30117-2463
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Country | US
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Telephone | 770-834-1091
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Fax |
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Provider Business Mailing Address
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Address Line | 5139 ACWORTH LANDING DR
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City | ACWORTH
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State | GA
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Zip | 30101-5346
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Country | US
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Telephone |
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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 | 031596
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License Number State | GA
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