Provider Demographics
NPI:1760840664
Name:CAREPOINT GEORGIA LLC
Entity Type:Organization
Organization Name:CAREPOINT GEORGIA LLC
Other - Org Name:CAREPOINT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRITI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-237-9112
Mailing Address - Street 1:PO BOX 532255
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-2255
Mailing Address - Country:US
Mailing Address - Phone:855-237-9112
Mailing Address - Fax:855-237-9113
Practice Address - Street 1:80 HORIZON DR STE 504-601A
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2936
Practice Address - Country:US
Practice Address - Phone:470-655-2480
Practice Address - Fax:855-237-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
GAPHRE0102603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003172849AMedicaid
2157967OtherPK