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Search › Georgia › 363L00000X

Anastacia Modo, NP

NPI 1831692110 · on the registry since 2018 · sole proprietor

Practice

Address
2496 Columbia Dr
Decatur, GA 30034
Phone
(404) 534-9222
Fax
(404) 534-9063
Organisation at this address
Wellfocus Pharmacy Llc
Ganesha Rx Care Group 2, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
363L00000X
363L00000X
Also registered as
363LF0000X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-04-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia