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General NPI Number Information
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NPI Number | 1851698252
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Entity Type | Individual
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Provider Name | CHRISTOPHER JASKOWIAK RPH
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Gender | Male
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Dates
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Enumeration Date | 02/21/2011
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Last Update Date | 02/21/2011
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Provider Practice Location Address
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Address Line | 1512 PIEDMONT AVE NE
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City | ATLANTA
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State | GA
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Zip | 30324-5044
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Country | US
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Telephone | 404-876-2263
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Fax |
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Provider Business Mailing Address
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Address Line | 1276 DIAMOND AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-3420
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Country | US
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Telephone | 404-542-9306
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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 | RPH021585
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License Number State | GA
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