Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Idesta Medical Inc

Organization Blood Banking & Transfusion Medicine Physician · NPI 1063185015

Idesta Medical Inc is a Blood Banking & Transfusion Medicine Physician in Tyrone, Georgia. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1015 Tyrone Rd # 410-C
Tyrone, GA 30290-2407
Phone: (470) 818-2264
Fax: (866) 984-3729
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Phlebotomy Technician (primary) Taxonomy 246RP1900X
Blood Banking & Transfusion Medicine Physician Taxonomy 207ZB0001X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1063185015
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Idesta Ralph — Owner · (239) 895-7910
NPI enumeratedJuly 27, 2021
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026
Mailing address4827 Old National Hwy Unit 2032, College Park, GA 30337-6234