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General NPI Number Information
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NPI Number | 1770307332
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Entity Type | Organization
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Legal Business Name | EMERALD CONCIERGE HEALTHCARE, INC
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 6555 SUGARLOAF PKWY STE 307-261
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City | DULUTH
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State | GA
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Zip | 30097-4930
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Country | US
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Telephone | 904-687-4431
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Fax |
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Provider Business Mailing Address
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Address Line | 6555 SUGARLOAF PKWY STE 307-261
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City | DULUTH
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State | GA
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Zip | 30097-4930
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARK OLMSTEAD
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Credential |
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Telephone | 904-687-4431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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