Provider Demographics
NPI:1447886056
Name:VERDUCI, SAWAPHA (RPH)
Entity type:Individual
Prefix:MRS
First Name:SAWAPHA
Middle Name:
Last Name:VERDUCI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-4622
Mailing Address - Country:US
Mailing Address - Phone:404-452-8989
Mailing Address - Fax:
Practice Address - Street 1:1375 THOMAS RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4622
Practice Address - Country:US
Practice Address - Phone:404-452-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-14
Last Update Date:2020-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist