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General NPI Number Information
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NPI Number | 1811860182
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Entity Type | Organization
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Legal Business Name | PEACH HEALTH CONCIERGE
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Dates
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Enumeration Date | 09/24/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 368 MCKENZIE DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6702
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Country | US
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Telephone | 910-723-2381
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Fax |
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Provider Business Mailing Address
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Address Line | 8735 DUNWOODY PL # 10682
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City | ATLANTA
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State | GA
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Zip | 30350-2995
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Country | US
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Telephone | 910-723-2381
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACINTA MOORE
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Credential | NP
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Telephone | 910-723-2381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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