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Organization
TRACY MEDICINE OF ATLANTA GA INC
Active
Organization
TRACY MEDICINE OF ATLANTA GA INC
Active
Other names
MEDICINE CENTER OF ATLANTA, INC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNAN LYNN TRACY PHARMACIST (PRESIDENT/OWNER)
(770) 934-7703
Entity
Organization
Contact information
Practice address
3650 CHAMBLEE TUCKER RD, CHAMBLEE, GA 30341-4420
(770) 934-7703
(770) 414-1463
Mailing address
3650 CHAMBLEE TUCKER RD, CHAMBLEE, GA 30341-4420
(770) 934-7703
(770) 414-1463
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
4501
GA
333600000X
Pharmacy
Primary
15042
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1107588
NABP NUMBER
GA
Enumeration date
09/02/2005
Last updated
07/29/2021
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