Organization
IHYDRATE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTEN VICTORIA QUEZADA RN (COFOUNDER)
(678) 690-0810
Entity
Organization
Contact information
Practice address
2810 PEACHTREE INDUSTRIAL BLVD STE D, DULUTH, GA 30097-8142
(855) 486-8773
Mailing address
5805 STATE BRIDGE RD # G83, JOHNS CREEK, GA 30097-8220
(855) 486-8773
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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