ID GROUP OF ATLANTA; NPI #1063833267

Contact Information

ID GROUP OF ATLANTA

735 PIEDMONT AVENUE, NE
ATLANTA, GA 30308

Phone: 404-588-4680
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Non-Pharmacy Dispensing Site	332900000X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for ID GROUP OF ATLANTA

NPI # 1063833267

LBN Legal business name ID GROUP OF ATLANTA

Authorized official JOHN OUDERKIRK - (MEMBER)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/16/2013

Last updated 12/16/2013 - About 12 years ago

Identifiers

GA	License #	049992
GA	Medicaid	000926318A

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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ID GROUP OF ATLANTA

Contact Information

Specialty

Non-Pharmacy Dispensing Site

NPI Profile & details for ID GROUP OF ATLANTA

Reviews for ID GROUP OF ATLANTA