Provider Demographics
NPI:1144840687
Name:WAHBA, GIRGIS (PHARMACIST)
Entity type:Individual
Prefix:
First Name:GIRGIS
Middle Name:
Last Name:WAHBA
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 SEVEN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6484
Mailing Address - Country:US
Mailing Address - Phone:347-659-2248
Mailing Address - Fax:
Practice Address - Street 1:2909 MURFREESBORO PIKE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-2227
Practice Address - Country:US
Practice Address - Phone:615-366-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39780183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist