# PRE WELLNESS CARE ATLANTA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1679111454
- **Authorized official:** ELIJUA WATSON (COO)
- **Authorized official phone:** (414) 238-4596

## Contact information

- **Practice address:** 2001 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30310-1101
- **Practice address phone:** (404) 691-3344
- **Mailing address:** 2001 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30310-1101
- **Mailing address phone:** (404) 691-3344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QG0250X | Genetics Clinic/Center | — | NULL | — |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP0905X | State or Local Public Health Clinic/Center | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 12/12/2019
- **Last updated:** 12/12/2019