Organization
NOAH'S ARK URGENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLA VERDENE JOHNSON PA-C (OWNER/MANAGER)
(470) 771-9677
Entity
Organization
Contact information
Practice address
950 EAGLES LANDING PKWY, SUITE 212, STOCKBRIDGE, GA 30281-7343
(470) 771-9677
Mailing address
950 EAGLES LANDING PKWY, SUITE 212, STOCKBRIDGE, GA 30281-7343
(470) 771-9677
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
003556
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
667084523B
—
GA
Enumeration date
08/26/2016
Last updated
09/17/2016
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