| Organization Name: | MEDICINE CENTER OF ATLANTA |
| NPI Number: | 1235348020 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM BRETT TRACY (PHARMACIST) |
| Mailing Address: | 3646 Chamblee Tucker Rd Suite C Chamblee |
| State: | GA US |
| Postal Code: | 303414406 |
| Phone Number: | 7709347703 |
| Fax Number: | 7704141463 |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 06/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0002X |
| License Number: | PHRE004501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Clinic Pharmacy |
| Taxonomy Definition: | A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |