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General NPI Number Information
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NPI Number | 1073837167
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Entity Type | Organization
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Legal Business Name | CRAWFORD LONG HOSPITAL
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1750 GAMBRELL DRIVE SUITE T203
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City | ATLANTA
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State | GA
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Zip | 30322
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Country | US
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Telephone | 404-778-2022
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Fax | 404-778-2025
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Provider Business Mailing Address
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Address Line | PO BOX 741066
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City | ATLANTA
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State | GA
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Zip | 30374-1066
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Country | US
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Telephone | 404-778-2022
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Fax | 404-778-2025
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Authorized Official
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Title or Position | CFO
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Name | AVA E DAUNT-SAMFORD
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Credential |
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Telephone | 404-686-4918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PHRE009637
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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