Provider Demographics
NPI:1962889626
Name:DALSANIA, RESHMA S (RPH)
Entity type:Individual
Prefix:MRS
First Name:RESHMA
Middle Name:S
Last Name:DALSANIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COBHAM DRAW
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-9618
Mailing Address - Country:US
Mailing Address - Phone:912-682-5447
Mailing Address - Fax:912-681-4337
Practice Address - Street 1:516 NORTHSIDE DR E
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-4841
Practice Address - Country:US
Practice Address - Phone:912-480-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH019535183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist