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Organization
GWINNETT PULMONARY GROUP DULUTH
Active
Organization
GWINNETT PULMONARY GROUP DULUTH
Active
Parent organization
GWINNETT PULMONARY GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
GWINNETT PULMONARY GROUP
Authorized official
JENNIFER THOMAS-ROLOFF (PRACTICE ADMINISTRATOR)
(678) 942-5985
Entity
Organization
Contact information
Practice address
3855 PLEASANT HILL RD STE 180, DULUTH, GA 30096-8093
(770) 995-0630
Mailing address
631 PROFESSIONAL DR STE 350, LAWRENCEVILLE, GA 30046-3370
(770) 995-0630
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
555819545SA
—
GA
Enumeration date
10/28/2019
Last updated
05/18/2021
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