# PEACHTREE IMMEDIATE CARE FP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peachtree Immediate Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023504180
- **Authorized official:** MRS. ANDREA MALIK-ROE (CFO)
- **Authorized official phone:** (678) 504-6392

## Contact information

- **Practice address:** 1025 VETERANS MEMORIAL HWY, SUITE 720, MABLETON, GA 30126-7239
- **Practice address phone:** (770) 732-0720
- **Practice address fax:** (770) 732-0730
- **Mailing address:** 1275 HIGHWAY 54 W STE 201, FAYETTEVILLE, GA 30214-4538
- **Mailing address phone:** (678) 688-9685
- **Mailing address fax:** (770) 626-3791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OCC010814 | GA | Yes |

## Other

- **Enumeration date:** 07/02/2018
- **Last updated:** 07/02/2018