Organization
WELLSTREET OF GEORGIA PC
Active
Organization
WELLSTREET OF GEORGIA PC
Active
Other names
Piedmont Urgentcare by Wellstreet
Organization subpart
No
Provider details
NPI number
Authorized official
TONIA RANA DAVIS (CREDENTIALING CORRDINATOR)
(770) 809-3036
Entity
Organization
Contact information
Practice address
921 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5011
(770) 692-5910
Mailing address
3350 RIVERWOOD PKWY SE STE 1850, ATLANTA, GA 30339-3300
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003177641A
—
GA
Enumeration date
04/25/2018
Last updated
11/19/2019
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