# PEACHSTREET IMMEDIATE CARE CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255518478
- **Authorized official:** MRS. DIEM NGUYEN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (678) 398-5440

## Contact information

- **Practice address:** 4426 AUSTELL RD, AUSTELL, GA 30106-1844
- **Practice address phone:** (678) 398-5440
- **Practice address fax:** (678) 398-5442
- **Mailing address:** 4426 AUSTELL RD, AUSTELL, GA 30106-1844
- **Mailing address phone:** (678) 398-5440
- **Mailing address fax:** (678) 398-5442

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/30/2008
- **Last updated:** 01/30/2008