Provider Demographics
NPI:1285441840
Name:THOMAS, ASHA ATHYAL (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:ATHYAL
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5948 MYRTLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2093
Mailing Address - Country:US
Mailing Address - Phone:678-294-4713
Mailing Address - Fax:
Practice Address - Street 1:375 ROCKBRIDGE RD NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-8225
Practice Address - Country:US
Practice Address - Phone:770-806-4045
Practice Address - Fax:770-806-4050
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH035270183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist