Organization
PERIDOT AND EMERALD MOBILE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLA MICHELLE STEPHENSON RN (ADMINISTRATOR)
(470) 545-0860
Entity
Organization
Contact information
Practice address
1315 MILSTEAD RD NE STE 101, CONYERS, GA 30012-3824
(470) 545-0860
(470) 300-7778
Mailing address
2890 GEORGIA HIGHWAY 212 SW STE A106, CONYERS, GA 30094-3363
(470) 545-0860
(470) 300-7778
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
04/17/2023
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