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Id Group of Atlanta — NPI 1063833267, Atlanta, GA | NPI Central

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NPI 1063833267

OrganizationActive

Id Group of Atlanta

NPI 1063833267 · Non-Pharmacy Dispensing Site · Atlanta, GA

Provider details

NPI number: 1063833267
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Organization subpart: No
Authorized official: John Ouderkirk, Member(404) 588-4680
License: 049992 (GA)

Specialties & taxonomies

Non-Pharmacy Dispensing SitePrimary332900000XLicense 049992 (GA)
Suppliers

Practice location

735 Piedmont Avenue, Ne

Atlanta, GA 30308

Phone: (404) 588-4680

Approximate (ZIP-level) locationGet directions

More GA providers

Mailing address

735 Piedmont Avenue, Ne

Atlanta, GA 30308

Registry dates

Enumerated: 2013-12-16
Last updated: 2013-12-16

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.