Deepa E Chacko
Pharmacist in Lilburn, GA. Individual provider (NPI-1).
NPI number1831473479
StatusActive
Last updated in NPPESSep 30, 2011
Details
- NPI
- 1831473479
- Entity type
- Individual (NPI-1)
- Name
- Deepa E Chacko
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2011
- Last updated
- Sep 30, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | RPH023873 | GA | Yes |
Practice location
4235 Lawrenceville HwyLilburn, GA 30047
Phone 770-921-7074 · Fax 770-921-7083
Mailing address
4235 Lawrenceville HwyLilburn, GA 30047
Phone 770-921-7074 · Fax 770-921-7083
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