WELLSTREET OF GEORGIA PC


Address: 1280 Dogwood Dr Se, Conyers, GA 30013-5046
Phone: 4049944662

WELLSTREET OF GEORGIA PC (NPI# 1063061315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063061315
Entity Type Organization
Organization Name WELLSTREET OF GEORGIA PC
Practice Address 1280 Dogwood Dr Se
Conyers
GA 30013-5046
Mailing Address 3350 Riverwood Pkwy Se Ste 1850
Atlanta
GA 30339-3300
Practice Telephone 4049944662
Practice Fax Number 4049944663
Mailing Telephone 7708093036
Mailing Fax Number 4046622399
Enumeration Date 2019-09-10
Last Update Date 2019-09-10
Authorized Official Name KEESHA D. PINACLE (CRED MGR)
Authorized Official Telephone 7708093036
Authorized Official Credential CREDENTIALING
Is Organization Subpart Y
Parent Organization Name WELLSTREET OF GEORGIA PC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332900000X Non-Pharmacy Dispensing Site Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
GA 003137211A 05

Other Provider/Organization Names

Other Name Type Code
Piedmont Urgent Care by Wellstreet Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1891265773 Wellstreet of Georgia PC Clinic/Center 1155 Concord Rd Se Ste 200, Smyrna, GA 30080-4207 2018-12-04
1861980955 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 4763 Atlanta Hwy Ste 420, Loganville, GA 30052-6788 2018-04-25
1184111338 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 10945 State Bridge Rd Ste 901, Alpharetta, GA 30022-8164 2018-04-13
1538666854 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 1575 Mount Vernon Rd, Dunwoody, GA 30338-4146 2018-04-12
1811494156 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 6063 Peachtree Pkwy Ste 210a, Peachtree Corners, GA 30092-3303 2018-04-12
1124532916 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 3617 Roswell Rd Ne Ste A, Atlanta, GA 30305-1111 2017-12-01
1730611088 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 6660 Roswell Rd, Sandy Springs, GA 30328-3167 2017-03-28
1508239997 Wellstreet of Georgia PC Clinic/Center 1825 Highway 34 E Ste 1200, Newnan, GA 30265-6416 2015-11-06
1487126637 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 1155 Concord Rd Se Ste 200, Smyrna, GA 30080-4207 2018-12-28
1538647441 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 5239 Highway 278 Ne, Covington, GA 30014-2671 2018-08-02

Office Location

Street Address 1280 DOGWOOD DR SE
City CONYERS
State GA
Zip Code 30013-5046

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144842295 Fit Therapy, LLC Physical Therapist 2008 Eastview Parkway, Suite 150, Conyers, GA 30013 2020-05-12
1144854753 Atl Optical LLC Optometrist 1285 Ga 138, Conyers, GA 30013 2020-02-24
1386201820 Achundris P Taylor Social Worker Harvest Grove Lane, Conyers, GA 30013 2019-05-21
1588153381 Curbside Medical Transporters Ambulance 2404 Brynlyn Woods Dr Ne, Conyers, GA 30013 2018-05-07
1184124877 Nursing Companion, LLC Homemaker 1064 Duke Dr, Conyers, GA 30013 2018-02-19
1588163638 Atlanta Plus Urgent Care Clinic/Center 2121 Salem Rd. Se, Conyers, GA 30013 2018-02-05
1043735244 Niki Tanyell Davis Licensed Practical Nurse 1403 Windy Hill Court, Conyers, GA 30013 2017-08-08
1063941490 Comprehensive Health and Rehab LLC Clinic/Center 2500 Riverton Drive, Conyers, GA 30013 2017-06-08
1306373188 Graceol Corporation Family Medicine 1035 Honey Creek Rd, Conyers, GA 30013 2017-05-11
1881149268 Jsa Dental Associates Conyers PC Dentist 1151 Nor Tec Dr, Suite B, Conyers, GA 30013 2016-08-16
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Taxonomy Information

Taxonomy Code 332900000X
Grouping Suppliers
Classification Non-Pharmacy Dispensing Site

Taxonomy Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1740823202 Gwinnett Pulmonary Group Duluth Non-Pharmacy Dispensing Site 3855 Pleasant Hill Rd Ste 180, Duluth, GA 30096-8093 2019-10-28
1659929339 Ankle and Foot Centers of Georgia, LLC Non-Pharmacy Dispensing Site 1975 Highway 54 W Ste 200, Peachtree City, GA 30269-4794 2019-08-27
1801444591 Ankle and Foot Centers of Georgia, LLC Non-Pharmacy Dispensing Site 2326 Highway 34 E Ste 200, Newnan, GA 30265-1328 2019-08-27
1225686991 Ankle and Foot Centers of Georgia, LLC Non-Pharmacy Dispensing Site 1819 Peachtree Rd Ne Ste 103, Atlanta, GA 30309-1848 2019-08-27
1265995724 Georgia Urology Pa Non-Pharmacy Dispensing Site 5900 Hillandale Dr Ste 200, Lithonia, GA 30058-3858 2019-04-11
1861980955 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 4763 Atlanta Hwy Ste 420, Loganville, GA 30052-6788 2018-04-25
1184111338 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 10945 State Bridge Rd Ste 901, Alpharetta, GA 30022-8164 2018-04-13
1538666854 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 1575 Mount Vernon Rd, Dunwoody, GA 30338-4146 2018-04-12
1811494156 Wellstreet of Georgia PC Non-Pharmacy Dispensing Site 6063 Peachtree Pkwy Ste 210a, Peachtree Corners, GA 30092-3303 2018-04-12
1851808539 Floyd Healthcare Management, Inc. Non-Pharmacy Dispensing Site 100 E 1st Ave, Rome, GA 30161-3212 2018-01-04
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Competitor

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City CONYERS
Zip Code 30013

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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