Organization
MYORGANICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANELLE LEWIS (ORGANIZER)
(347) 313-2205
Entity
Organization
Contact information
Practice address
5910 SHADOW ROCK DR, LITHONIA, GA 30058
(347) 313-2205
Mailing address
5910 SHADOW ROCK DR, LITHONIA, GA 30058-3232
(347) 313-2205
Taxonomy
Speciality
Code
Description
License number
State
246QL0900X
Laboratory Management Specialist/Technologist
—
—
246RP1900X
Phlebotomy Technician
Primary
—
GA
Other
Enumeration date
07/16/2018
Last updated
07/19/2018
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