Organization
WELLSTREET OF GEORGIA PC
Active
Other names
Piedmont Urgent Care by Wellstreet
Organization subpart
No
Provider details
NPI number
Authorized official
KEESHA D. PINACLE (CREDENTIALING MANAGER)
(770) 809-3036
Entity
Organization
Contact information
Practice address
1155 CONCORD RD SE STE 200, SMYRNA, GA 30080-4207
(678) 600-5137
(678) 600-5098
Mailing address
3350 RIVERWOOD PKWY SE STE 1850, ATLANTA, GA 30339-3300
(770) 809-3036
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137211A
—
GA
Enumeration date
12/28/2018
Last updated
12/28/2018
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