ELITE IV HYDRATION AND WELLNESS NPI 1730843202

NPI Information

  • NPI: 1730843202
  • Provider Name: ELITE IV HYDRATION AND WELLNESS
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 823 PAVILION CT
    MCDONOUGH, GA
    ZIP 30253
  • Phone: (404) 965-5715

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NPI Details

ELITE IV HYDRATION AND WELLNESS is a clinic center in Mcdonough, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). ELITE IV HYDRATION AND WELLNESS NPI is 1730843202. The provider is registered as an organization entity type.

The provider's business location address is:

823 PAVILION CT
MCDONOUGH, GA
ZIP 30253-666
Phone: (404) 965-5715

The provider's authorized official is Tanika Ramsey Powell .
The authorized official title is Nurse Practitioner/owner and has the following contact phone number (706) 399-4601.

The enumeration date for this NPI number is 10/29/2021 and was last updated on 6/30/2023.

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
1291U00000XClinical Medical LaboratoryNo
2261Q00000XClinic/CenterYes

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: 11/21/2025

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