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Organization

DEKALB GPO LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN PALLONE (PRACTICE ADMINISTRATOR)
(404) 296-5005
Entity
Organization

Contact information

Practice address
2801 N DECATUR RD, SUITE 200, DECATUR, GA 30033-5949
(404) 296-5005
(404) 296-9417
Mailing address
2801 N DECATUR RD, SUITE 200, DECATUR, GA 30033-5949
(404) 296-5005
(404) 296-9417

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary

Other

Enumeration date
03/24/2014
Last updated
03/24/2014
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