Provider Demographics
NPI:1992559629
Name:WEST COBB SPECIALTY PHARMACY INC
Entity type:Organization
Organization Name:WEST COBB SPECIALTY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JITENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-485-0575
Mailing Address - Street 1:933 PEACHTREE ST NE STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-7901
Mailing Address - Country:US
Mailing Address - Phone:770-485-0575
Mailing Address - Fax:877-411-0199
Practice Address - Street 1:933 PEACHTREE ST NE STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-7901
Practice Address - Country:US
Practice Address - Phone:770-485-0575
Practice Address - Fax:877-411-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy