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General NPI Number Information
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NPI Number | 1942834411
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Entity Type | Organization
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Legal Business Name | PREGNANCY RESOURCE CENTER OF GWINNETT
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 565 OLD NORCROSS RD SUITE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 770-338-1680
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Fax | 770-338-7329
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Provider Business Mailing Address
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Address Line | 565 OLD NORCROSS RD SUITE 200
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 770-338-1680
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Fax | 770-338-7329
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. ROBIN E MAUCK
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Credential |
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Telephone | 770-338-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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