Provider Demographics
NPI:1053584508
Name:PRICELESS PRIMARY HEALTH CARE OF ATLANTA INC
Entity type:Organization
Organization Name:PRICELESS PRIMARY HEALTH CARE OF ATLANTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-583-8988
Mailing Address - Street 1:119 GRIFFIN ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-3123
Mailing Address - Country:US
Mailing Address - Phone:678-583-8988
Mailing Address - Fax:678-583-8994
Practice Address - Street 1:119 GRIFFIN ST
Practice Address - Street 2:SUITE 100B
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3123
Practice Address - Country:US
Practice Address - Phone:678-583-8988
Practice Address - Fax:678-583-8994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty