George Joseph Siffri, PHARMD

Individual provider Active NPI Nutrition Support Pharmacist · Cumming, GA

NPI 1720072119 · NPPES record last updated Apr 19, 2011

Key facts

NPI
1720072119
Entity type
Individual (NPI type 1)
Primary specialty
Nutrition Support Pharmacist 1835N1003X
License
RPH011942 (GA)
Practice address
1200 Northside Forsyth Dr
Pharmacy Department
Cumming, GA 30041-7659
Phone
(770) 844-3290
Fax
(770) 844-3424
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH011942GAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Support Pharmacist 1835N1003X RPH011942 GA Yes
Pharmacist 183500000X RPH011942 GA

Addresses

Primary practice location

1200 Northside Forsyth Dr
Pharmacy Department
Cumming, GA 30041-7659

Mailing address

50 Mount Whitney PL
Johns Creek, GA 30022-5441
Phone (404) 434-3968

Other providers in Cumming, GA

All providers in Cumming, GA · Nutrition Support Pharmacist in Georgia

Sources for this page

Verify at the official NPI Registry.