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General NPI Number Information
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NPI Number | 1932820719
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Entity Type | Organization
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Legal Business Name | ATLANTA HIV CONSULTANTS
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1000 IRIS DR SW STE E9
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City | CONYERS
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State | GA
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Zip | 30094-6632
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Country | US
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Telephone | 833-448-4636
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Fax | 833-448-4636
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Provider Business Mailing Address
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Address Line | 1000 IRIS DR SW STE E9
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City | CONYERS
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State | GA
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Zip | 30094-6632
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Country | US
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Telephone | 833-448-4636
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DR. CASANDRA M. KIDD
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Credential | DRPH
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Telephone | 404-791-7201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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