Periyasamy Thandavan, Sudharsan
Periyasamy Thandavan, Sudharsan is an individual health care provider with primary practice located at 2744 Washington Rd , Augusta GA 30909-2218. He recently has only one registered license in Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, which is considered as his primary health care specialty. Periyasamy Thandavan, Sudharsan can be contacted via phone (706) 733-4277.Contact Information
Primary practice address
2744 Washington Rd
Augusta GA 30909-2218
Phone: (706) 733-4277
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | RPH028705 | Georgia |
Profile Details
NPI number | 1457726663 |
---|---|
LBN Legal business name | Periyasamy Thandavan, Sudharsan |
Credentials | PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 14th, 2015 |
Last updated | Dec 14th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1457726663 | NPPES |
Georgia | Other | UIJ945A15732 | BLUECROSS BLUESHEILD |
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