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General NPI Number Information
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NPI Number | 1871197962
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Entity Type | Individual
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Provider Name | MARK RHA
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Gender | Male
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 4600 ROSWELL RD UNIT F100
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City | SANDY SPRINGS
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State | GA
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Zip | 30342-3181
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Country | US
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Telephone | 404-236-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 4375 WHITE SPRUCE ALY
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City | DORAVILLE
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State | GA
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Zip | 30360-5503
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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 | RPH030662
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License Number State | GA
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