Provider Demographics
NPI:1104429703
Name:FRANCESCONI, STEVE
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:FRANCESCONI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 PACES FERRY RD SE BLDG C
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6444
Mailing Address - Country:US
Mailing Address - Phone:770-433-2722
Mailing Address - Fax:
Practice Address - Street 1:2455 PACES FERRY RD SE BLDG C
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6444
Practice Address - Country:US
Practice Address - Phone:770-433-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA019837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA019837OtherGEORGIA BOARD OF PHARMACY