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General NPI Number Information
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NPI Number | 1225162894
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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 | 03/15/2007
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 1863 MEMORIAL DR SE
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City | ATLANTA
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State | GA
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Zip | 30317-2103
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Country | US
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Telephone | 404-616-9351
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Fax | 404-616-6555
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Provider Business Mailing Address
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Address Line | PHARMACY ADMINISTRATION-26041 80 JESSE HILL JR DRIVE
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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 | 404-616-9351
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Fax | 404-616-6070
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY ADMINISTRATION
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Name | VALAURA HALLMAN
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Credential |
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Telephone | 404-616-3576
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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 |
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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 | 5599
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License Number State | GA
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