Healthcare Provider Details

I. General information

NPI: 1336945807
Provider Name (Legal Business Name): QUICK CARE CLINIC GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S MARIETTA PKWY SE STE 203
MARIETTA GA
30067-7844
US

IV. Provider business mailing address

1400 S MARIETTA PKWY SE STE 203
MARIETTA GA
30067-7844
US

V. Phone/Fax

Practice location:
  • Phone: 678-935-9939
  • Fax: 678-935-9974
Mailing address:
  • Phone: 678-935-9939
  • Fax: 678-935-9974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. TANISHA HODGE
Title or Position: COO
Credential:
Phone: 678-935-9939