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General NPI Number Information
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NPI Number | 1225688369
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Entity Type | Organization
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Legal Business Name | PULSE FAMILY MEDICINE AND DIAGNOSTICS
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Dates
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Enumeration Date | 09/19/2019
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 2295 PARKLAKE DR NE STE 425
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City | ATLANTA
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State | GA
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Zip | 30345-2812
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Country | US
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Telephone | 470-268-6178
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Fax |
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Provider Business Mailing Address
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Address Line | 2295 PARKLAKE DR NE STE 425
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City | ATLANTA
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State | GA
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Zip | 30345-2812
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Country | US
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Telephone | 470-268-6178
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GWENDOLYN MCRAE
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Credential |
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Telephone | 470-300-8721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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