Organization
TRACY MEDICINE OF ATLANTA GA INC
Active
Other names
MEDICINE CENTER OF ATLANTA, INC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNAN LYNN TRACY PHARMACIST (PRESIDENT/OWNER)
(770) 934-7703
Entity
Organization
Contact information
Practice address
3650 CHAMBLEE TUCKER RD, CHAMBLEE, GA 30341-4420
(770) 934-7703
(770) 414-1463
Mailing address
3650 CHAMBLEE TUCKER RD, CHAMBLEE, GA 30341-4420
(770) 934-7703
(770) 414-1463
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
4501
GA
333600000X
Pharmacy
Primary
15042
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1107588
NABP NUMBER
GA
Enumeration date
09/02/2005
Last updated
07/29/2021
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