# GWINNETT PULMONARY GROUP DULUTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GWINNETT PULMONARY GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740823202
- **Legal business name:** GWINNETT PULMONARY GROUP
- **Authorized official:** JENNIFER THOMAS-ROLOFF (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (678) 942-5985

## Contact information

- **Practice address:** 3855 PLEASANT HILL RD STE 180, DULUTH, GA 30096-8093
- **Practice address phone:** (770) 995-0630
- **Mailing address:** 631 PROFESSIONAL DR STE 350, LAWRENCEVILLE, GA 30046-3370
- **Mailing address phone:** (770) 995-0630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/28/2019
- **Last updated:** 05/18/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 555819545SA | — | GA |