Healthcare Provider Details

I. General information

NPI: 1306090121
Provider Name (Legal Business Name): RST GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 POWERS FERRY RD NW STE 600
ATLANTA GA
30339-2961
US

IV. Provider business mailing address

6300 POWERS FERRY RD NW STE 600
ATLANTA GA
30339-2961
US

V. Phone/Fax

Practice location:
  • Phone: 404-769-2216
  • Fax:
Mailing address:
  • Phone: 404-769-2216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SANTIAGO T RODRIGUEZ
Title or Position: CEO
Credential:
Phone: 404-769-2216