Organization
EGLESTON AFFILIATED SERVICES
Active
Other names
Children's Healthcare of Atlanta at West Cobb
Organization subpart
No
Provider details
NPI number
Authorized official
LOUETTA CODY (MANAGER, PROVIDER ENROLLMENT)
(404) 785-7876
Entity
Organization
Contact information
Practice address
2041 MESA VALLEY WAY, SUITE 185, AUSTELL, GA 30106
(404) 785-8900
Mailing address
1584 TULLIE CIR NE, ATLANTA, GA 30329-2311
(404) 785-7928
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
044-079
GA
Other
Enumeration date
11/20/2006
Last updated
04/03/2023
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