# WELLSTREET OF GEORGIA PC

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

## Provider details

- **NPI number:** 1447915046
- **Authorized official:** HEATHER BROCK (CRED SUPERVISOR)
- **Authorized official phone:** (678) 770-9005

## Contact information

- **Practice address:** 7820 HICKORY FLAT HWY, WOODSTOCK, GA 30188-2099
- **Practice address phone:** (678) 672-5100
- **Mailing address:** 3350 RIVERWOOD PKWY SE STE 1850, ATLANTA, GA 30339-3300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 11/08/2021
- **Last updated:** 11/08/2021