MEDICARE: CAREPOINT GEORGIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHRE010260	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2157967	OTHER		PK

General Provider Information

NPI Number	:	1760840664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREPOINT GEORGIA LLC

Provider Business Mailing Address
First Line	:	PO BOX 532255
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-2255
Country	:	US
Telephone Number	:	855-237-9112
Fax Number	:	855-237-9113

Provider Business Practice Location Address
First Line	:	80 HORIZON DR STE 504-601A
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-2936
Country	:	US
Telephone Number	:	470-655-2480
Fax Number	:	855-237-9113

Authorized Official
Title or Position	:	OWNER
Name	:	PRITI PATEL
Credential	:
Telephone Number	:	855-237-9112

Provider Enumeration Date	:	02/05/2016
Last Update Date	:	11/17/2016

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Directions to “CAREPOINT GEORGIA LLC ” Practice Location

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