Organization
GWINNETT PULMONARY GROUP DULUTH
Active
Parent organization
GWINNETT PULMONARY GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
GWINNETT PULMONARY GROUP
Authorized official
JENNIFER THOMAS-ROLOFF (PRACTICE ADMINISTRATOR)
(678) 942-5985
Entity
Organization
Contact information
Practice address
3855 PLEASANT HILL RD STE 180, DULUTH, GA 30096-8093
(770) 995-0630
Mailing address
631 PROFESSIONAL DR STE 350, LAWRENCEVILLE, GA 30046-3370
(770) 995-0630
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
555819545SA
—
GA
Enumeration date
10/28/2019
Last updated
05/18/2021
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