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General NPI Number Information
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NPI Number | 1972519106
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Entity Type | Organization
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Legal Business Name | CONCORD INC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 993-D JOHNSON FERRY RD SUITE 230
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-255-0526
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Fax | 404-255-6357
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Provider Business Mailing Address
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Address Line | 8046 ROSWELL RD SUITE 202
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City | ATLANTA
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State | GA
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Zip | 30350-7023
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Country | US
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Telephone | 770-671-0657
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Fax | 770-393-0835
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Authorized Official
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Title or Position | CORPORATE SECRETARY
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Name | LISA A MCCORD
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Credential |
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Telephone | 770-671-0657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE006062
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License Number State | GA
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