Organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE FARMER (DIRECTOR OF LABORATORY SERVICES)
(404) 309-9314
Entity
Organization
Contact information
Practice address
200 CRESCENT CENTER PKWY, TUCKER, GA 30084-7047
(770) 496-3515
Mailing address
3495 PIEDMONT RD NE, ATLANTA, GA 30305-1773
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
11D0259510
GA
Other
Enumeration date
07/03/2008
Last updated
07/15/2021
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