MEDPRIME LLC NPI 1265711634

NPI Information

NPI: 1265711634
Provider Name: MEDPRIME, LLC

Doing Business As: WELLNESS PLUS CLINIC

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
3 RAVINIA DR
SUITE P-160
ATLANTA, GA
ZIP 30346
Phone: (770) 392-7160
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MEDPRIME, LLC is a general practice in Atlanta, GA. MEDPRIME, LLC NPI is 1265711634. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Wellness Plus Clinic.

The provider's business location address is:

3 RAVINIA DR
SUITE P-160
ATLANTA, GA
ZIP 30346-118
Phone: (770) 392-7160
Fax: (770) 392-7163

The provider's authorized official is Mark Reznik .
The authorized official title is Practice Administrator and has the following contact phone number (770) 392-7160.

The enumeration date for this NPI number is 8/16/2011 and was last updated on 8/16/2011.

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	111N00000X	Chiropractor		CHIRO07312	GEORGIA	No
2	208D00000X	General Practice		044023	GEORGIA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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