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General NPI Number Information
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NPI Number | 1093177883
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Entity Type | Organization
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Legal Business Name | EASTSIDE URGENT CARE, LLC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 3370 SUGARLOAF PKWY SUITE A
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-5478
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Country | US
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Telephone | 678-895-9275
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Fax | 404-410-7707
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Provider Business Mailing Address
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Address Line | 450 14TH ST NW
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City | ATLANTA
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State | GA
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Zip | 30318-7963
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Country | US
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Telephone | 770-884-4399
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Fax | 404-410-7707
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. NAVREET PANNU
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Credential |
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Telephone | 678-895-9275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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