Healthcare Provider Details

I. General information

NPI: 1699778563
Provider Name (Legal Business Name): HEMOPHILIA OF GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8607 ROBERTS DR STE 150
SANDY SPRINGS GA
30350-2237
US

IV. Provider business mailing address

8607 ROBERTS DR STE 150
SANDY SPRINGS GA
30350-2237
US

V. Phone/Fax

Practice location:
  • Phone: 770-518-8272
  • Fax: 770-518-3310
Mailing address:
  • Phone: 770-518-8272
  • Fax: 770-518-3310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHRE007480
License Number StateGA

VIII. Authorized Official

Name: JULIE WILKS HAYMAN
Title or Position: VP, PAYER RELATIONS AND REV. CYCLE
Credential:
Phone: 770-518-8272