Healthcare Provider Details

I. General information

NPI: 1144203563
Provider Name (Legal Business Name): CRAWFORD LONG HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 03/12/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE
ATLANTA GA
30308
US

IV. Provider business mailing address

550 PEACHTREE ST NE
ATLANTA GA
30308
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-7519
  • Fax: 404-686-4887
Mailing address:
  • Phone: 404-686-2009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: AVA E DAUNT-SAMFORD
Title or Position: CFO
Credential:
Phone: 404-686-4918