Ihydrate LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

IHYDRATE LLC

Practice address

2810 Peachtree Industrial Blvd Ste D
Duluth, GA 30097-8142

Phone

(855) 486-8773

NPI assigned

Oct 25, 2021

Last updated

Oct 25, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christen Victoria Quezada, RN

Title

Cofounder

Phone

(678) 690-0810

Specialties & licenses 4

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1235893462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5805 STATE BRIDGE RD # G83",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978220",
            "telephone_number": "855-486-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 PEACHTREE INDUSTRIAL BLVD STE D",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978142",
            "telephone_number": "855-486-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHYDRATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "QUEZADA",
        "authorized_official_first_name": "CHRISTEN",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "COFOUNDER",
        "authorized_official_telephone_number": "678-690-0810",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Duluth, GA
• Providers in Duluth, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.