Healthcare Provider Details

I. General information

NPI: 1598795585
Provider Name (Legal Business Name): WELLSTAR ATLANTA MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/31/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 PARKWAY DR NE
ATLANTA GA
30312-1212
US

IV. Provider business mailing address

1800 PARKWAY PL SE STE 500
MARIETTA GA
30067-8237
US

V. Phone/Fax

Practice location:
  • Phone: 404-265-4000
  • Fax:
Mailing address:
  • Phone: 470-956-4981
  • Fax: 770-792-5272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number060-551
License Number StateGA

VIII. Authorized Official

Name: MR. ANTHONY J BUDZINSKI
Title or Position: EVP
Credential:
Phone: 470-644-0012