Provider Demographics
NPI:1932820719
Name:ATLANTA HIV CONSULTANTS
Entity type:Organization
Organization Name:ATLANTA HIV CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:CASANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH
Authorized Official - Phone:404-791-7201
Mailing Address - Street 1:1000 IRIS DR SW STE E9
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-6632
Mailing Address - Country:US
Mailing Address - Phone:833-448-4636
Mailing Address - Fax:
Practice Address - Street 1:1000 IRIS DR SW STE E9
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6632
Practice Address - Country:US
Practice Address - Phone:833-448-4636
Practice Address - Fax:833-448-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician