Active NPI
Tofique Nizami Usta, PHARMD
- Pharmacist
- Suwanee, GA
National Provider Identifier
1841599040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH020565
- Practice address
- 2075 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2645 - Phone
- (678) 377-5258
- Fax
- (678) 377-0568
- NPI assigned
- Mar 28, 2011
- Last updated
- Dec 27, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH020565 | GA | Primary |
Addresses
Primary practice location
2075 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2645
Mailing address
2075 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2645
Phone (678) 377-5258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH020565 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2075 Lawrenceville Suwanee Rd
Suwanee, GA 30024
Phone (678) 377-5258
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672099200000",
"number": "1841599040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2075 LAWRENCEVILLE SUWANEE RD",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300242645",
"telephone_number": "678-377-5258",
"fax_number": "678-377-0568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2075 LAWRENCEVILLE SUWANEE RD",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300242645",
"telephone_number": "678-377-5258",
"fax_number": "678-377-0568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "USTA",
"first_name": "TOFIQUE",
"middle_name": "NIZAMI",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-28",
"last_updated": "2022-12-27",
"certification_date": "2022-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH020565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.