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Organization
WELLSTREET OF GEORGIA PC
Active
Organization
WELLSTREET OF GEORGIA PC
Active
Other names
Piedmont Urgent Care by Wellstreet
Organization subpart
No
Provider details
NPI number
Authorized official
KEESHA D. PINACLE (CREDENTIALING MANAGER)
(770) 809-3036
Entity
Organization
Contact information
Practice address
1155 CONCORD RD SE STE 200, SMYRNA, GA 30080-4207
(678) 600-5137
(678) 600-5098
Mailing address
3350 RIVERWOOD PKWY SE STE 1850, ATLANTA, GA 30339-3300
(770) 809-3036
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137211A
—
GA
Enumeration date
12/28/2018
Last updated
12/28/2018
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