ID GROUP OF ATLANTA NPI 1063833267

NPI Information

NPI: 1063833267
Provider Name: ID GROUP OF ATLANTA
Classification: Non-Pharmacy Dispensing Site - 332900000X
Entity Type: Organization
Address:
735 PIEDMONT AVENUE, NE
ATLANTA, GA
ZIP 30308
Phone: (404) 588-4680
Get Directions

ID GROUP OF ATLANTA is a non pharmacy dispensing site in Atlanta, GA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) ID GROUP OF ATLANTA NPI is 1063833267. The provider is registered as an organization entity type.

The provider's business location address is:

735 PIEDMONT AVENUE, NE
ATLANTA, GA
ZIP 30308
Phone: (404) 588-4680

The provider's authorized official is John P Ouderkirk .
The authorized official title is Member and has the following contact phone number (404) 588-4680.

The enumeration date for this NPI number is 12/16/2013 and was last updated on 12/16/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332900000X	Non-Pharmacy Dispensing Site		049992	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000926318A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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