# DEKALB COMMUNITY SERVICE BOARD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** DeKalb Crisis Center Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164199311
- **Authorized official:** MR. FABIO BRUNO VAN DER MERWE (CEO)
- **Authorized official phone:** (404) 294-3836

## Contact information

- **Practice address:** 450 WINN WAY, DECATUR, GA 30030-1715
- **Practice address phone:** (404) 508-7774
- **Mailing address:** 445 WINN WAY FL 4, DECATUR, GA 30030-1707
- **Mailing address phone:** (404) 294-3836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/25/2021
- **Last updated:** 08/25/2021