| Elite Iv Hydration And Wellness | |
|
823 Pavilion Ct Mcdonough GA 30253-6666 | |
| (404) 965-5715 | |
| Not Available |
| Full Name | Elite Iv Hydration And Wellness |
|---|---|
| Speciality | Clinic/center |
| Location | 823 Pavilion Ct, Mcdonough, Georgia |
| Authorized Official Name and Position | Tanika Ramsey Powell (NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 7063994601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Iv Hydration And Wellness 5916 East Lake Pkwy Suite 324 Mcdonough GA 30253 Ph: (706) 399-4601 | Elite Iv Hydration And Wellness 823 Pavilion Ct Mcdonough GA 30253-6666 Ph: (404) 965-5715 |
| NPI Number | 1730843202 |
|---|---|
| Provider Enumeration Date | 10/29/2021 |
| Last Update Date | 06/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730843202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |
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