PACT ATLANTA LLC NPI 1114092202

NPI Information

  • NPI: 1114092202
  • Provider Name: PACT ATLANTA, LLC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 465 WINN WAY STE 221
    DECATUR, GA
    ZIP 30030
  • Phone: (404) 292-3810

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NPI Details

PACT ATLANTA, LLC is a medical specialty clinic center in Decatur, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). PACT ATLANTA, LLC NPI is 1114092202. The provider is registered as an organization entity type.

The provider's business location address is:

465 WINN WAY STE 221
DECATUR, GA
ZIP 30030-723
Phone: (404) 292-3810
Fax: (404) 292-3848

The provider's authorized official is Todd M Antin .
The authorized official title is Ceo and has the following contact phone number (404) 292-3810.

The enumeration date for this NPI number is 11/22/2006 and was last updated on 8/22/2020.

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
1261QM2500XClinic/CenterMedical Specialty036495GEORGIAYes

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: 3/30/2025

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