Provider Demographics
NPI:1043378763
Name:TAB SAFE PRESCRIPTION SERVICES
Entity type:Organization
Organization Name:TAB SAFE PRESCRIPTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHIAVETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-990-8450
Mailing Address - Street 1:1050 NORTHFIELD COURT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076
Mailing Address - Country:US
Mailing Address - Phone:678-990-8450
Mailing Address - Fax:678-990-8456
Practice Address - Street 1:1050 NORTHFIELD COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076
Practice Address - Country:US
Practice Address - Phone:678-990-8450
Practice Address - Fax:678-990-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5164410001Medicare ID - Type Unspecified