Healthcare Provider Details
I. General information
NPI: 1710784616
Provider Name (Legal Business Name): MGS WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2025
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2180 SATELLITE BLVD STE 400
DULUTH GA
30097-4927
US
IV. Provider business mailing address
2180 SATELLITE BLVD STE 400
DULUTH GA
30097-4927
US
V. Phone/Fax
- Phone: 404-941-4776
- Fax:
- Phone: 404-941-4776
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARSHAUNA
SAGESSE
Title or Position: OWNER/PHARMACIST
Credential: PHARMD
Phone: 404-941-4776