Provider Demographics
NPI:1174123947
Name:ORAGUI, CHISADO DELPHINE
Entity type:Individual
Prefix:
First Name:CHISADO
Middle Name:DELPHINE
Last Name:ORAGUI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CREEKSIDE PARK DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8103
Mailing Address - Country:US
Mailing Address - Phone:678-602-1941
Mailing Address - Fax:
Practice Address - Street 1:4735 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-1915
Practice Address - Country:US
Practice Address - Phone:770-964-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist