Provider Demographics
NPI:1710074505
Name:GERIATRIC CARE CONSULTANTS
Entity Type:Organization
Organization Name:GERIATRIC CARE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:770-489-2110
Mailing Address - Street 1:3641 LANIER DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-7165
Mailing Address - Country:US
Mailing Address - Phone:770-489-2110
Mailing Address - Fax:770-732-5514
Practice Address - Street 1:3641 LANIER DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-7165
Practice Address - Country:US
Practice Address - Phone:770-489-2110
Practice Address - Fax:770-732-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0224551835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Multi-Specialty