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General NPI Number Information
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NPI Number | 1124598362
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Entity Type | Organization
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Legal Business Name | GRADY MEMORIAL HOSPITAL CORPORATION
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 80 GILMER STREET ROOM 8570
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City | ATLANTA
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State | GA
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Zip | 30303
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Country | US
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Telephone | 404-489-9144
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Fax |
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Provider Business Mailing Address
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Address Line | 80 JESSE HILL JR DR SE PHARMACY ADMINISTRATION, BOX 26041
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City | ATLANTA
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State | GA
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Zip | 30303
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Country | US
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Telephone | 404-616-3415
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Fax | 404-616-6070
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR OF AMB PHARMACY
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Name | DR. MARY KATHERINE CHEELEY
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Credential | PHARMD
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Telephone | 404-616-5711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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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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