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Individual

BEEMNET HAILU ASEGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5755 ROCKBRIDGE RD, STONE MOUNTAIN, GA 30087-5702
(770) 469-7991
Mailing address
882 CONNERS CV, LAWRENCEVILLE, GA 30044-6934

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PS59345
FL
3336C0003X
Community/Retail Pharmacy
RPHT00259
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PS59345
PHARMACIST
FL
01
RPHT00259
PHARMACY
GA
Enumeration date
11/02/2022
Last updated
11/02/2022
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