Egleston Affliated Services
Clinic/Center, Urgent Care in Duluth, GA. Organization (NPI-2).
NPI number1073687331
StatusActive
Last updated in NPPESApr 3, 2023
Details
- NPI
- 1073687331
- Entity type
- Organization (NPI-2)
- Legal business name
- Egleston Affliated Services
- Organization subpart
- No
- Enumeration date
- Nov 20, 2006
- Certification date
- Apr 3, 2023
- Last updated
- Apr 3, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QU0200X | Clinic/Center, Urgent Care | 044-079 | GA | Yes |
Other names
- Children'S Healthcare Of Atlanta At Mount Zion (Other Name)
Practice location
2660 Satellite BlvdDuluth, GA 30096-5803
Phone 404-785-8330
Mailing address
1584 Tullie Cir NeAtlanta, GA 30329-2311
Phone 404-785-7928
Authorized official
Louetta Cody
Manager, Provider Enrollment
4047857876
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