Provider Demographics
NPI:1538411418
Name:KAUR, JATINDER (RPH)
Entity type:Individual
Prefix:
First Name:JATINDER
Middle Name:
Last Name:KAUR
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 1:750 LOCKS WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4972
Mailing Address - Country:US
Mailing Address - Phone:626-278-4979
Mailing Address - Fax:
Practice Address - Street 1:1633 GORDON HWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-2220
Practice Address - Country:US
Practice Address - Phone:706-792-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58633183500000X
SC13184183500000X
GA26330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist