Healthcare Provider Details

I. General information

NPI: 1497814057
Provider Name (Legal Business Name): EMORY UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE BLDG B
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

1109 VERNON ST
LAGRANGE GA
30240-2939
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3748
  • Fax:
Mailing address:
  • Phone:
  • 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: MS. DOROTHY COOK-WALTER
Title or Position: DIRECTOR
Credential:
Phone: 404-778-2144