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General NPI Number Information
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NPI Number | 1629400460
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Entity Type | Organization
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Legal Business Name | LEVEL 10 CONSULTING GROUP, LLC
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Dates
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Enumeration Date | 08/03/2013
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Last Update Date | 08/03/2013
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Provider Practice Location Address
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Address Line | 303 PERIMETER CTR N SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30346-3402
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Country | US
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Telephone | 770-329-5757
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Fax | 770-594-9108
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Provider Business Mailing Address
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Address Line | 303 PERIMETER CTR N SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30346-3402
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Country | US
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Telephone | 770-329-5757
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Fax | 770-594-9108
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Authorized Official
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Title or Position | PRESIDENT
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Name | JERRUND THOMAS WILKERSON
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Credential | RPH
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Telephone | 770-329-5757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | RPH019148
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License Number State | GA
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