<Unavail>
LBN: Express At Northside Llc
<Unavail> is an health care organization with primary practice located at 296 Northside Dr Sw , Atlanta GA 30313-1228. The organization recently has 4 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Specialty Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Express At Northside Llc can be contacted via phone (404) 549-7762, or through Trivedi, Ketan via phone (678) 205-7038.
Contact Information
Primary practice address
296 Northside Dr Sw
Atlanta GA 30313-1228
Phone: (404) 549-7762
Fax: (404) 549-7625
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHRE010415 | Georgia |
| Suppliers / Compounding Pharmacy | 3336C0004X | ||
| Suppliers / Specialty Pharmacy | 3336S0011X |
Profile Details
| NPI number | 1285145789 |
|---|---|
| LBN Legal business name | Express At Northside Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Trivedi, Ketan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 24th, 2017 |
| Last updated | Sep 19th, 2025 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285145789 | NPPES |
| Georgia | MEDICAID | 003199602A | |
| Georgia | Other | 2172400 |
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