LOCUST GROVE FAMILY MEDICINE is a non pharmacy dispensing site in Locust Grove, 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.) LOCUST GROVE FAMILY MEDICINE NPI is 1629169164. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
3778 HIGHWAY 42
LOCUST GROVE, GA
ZIP 30248-632
Phone: (678) 610-6649
Fax: (678) 610-6025
The provider's authorized official is Nimisha J Trivedi .
The authorized official title is Owner and has the following contact phone number (678) 610-6649.
The CLIA number assigned to this NPI record is 11D1017382 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).
The enumeration date for this NPI number is 9/28/2006 and was last updated on 3/14/2016.