Provider Demographics
NPI:1821592593
Name:PEDPOST FOUNDATION INC
Entity Type:Organization
Organization Name:PEDPOST FOUNDATION INC
Other - Org Name:PEDPOST FOUNDATION INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ESEOVHE
Authorized Official - Middle Name:
Authorized Official - Last Name:EGBORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-222-0375
Mailing Address - Street 1:12600 DEERFIELD PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-6130
Mailing Address - Country:US
Mailing Address - Phone:470-222-0375
Mailing Address - Fax:
Practice Address - Street 1:12600 DEERFIELD PKWY STE 100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6130
Practice Address - Country:US
Practice Address - Phone:470-222-0375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA77128OtherSTATE LICENSE