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General NPI Number Information
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NPI Number | 1295616845
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Entity Type | Organization
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Legal Business Name | DEKALB MEDICAL CENTER INC, DBA EMORY DECATUR HOSPITAL
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 2675 N DECATUR RD STE 212
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City | DECATUR
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State | GA
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Zip | 30033-6132
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Country | US
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Telephone | 404-501-4680
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Fax |
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Provider Business Mailing Address
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Address Line | 2675 N DECATUR RD STE 212
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City | DECATUR
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State | GA
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Zip | 30033-6132
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP/CFO
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Name | LISA URBISTONDO
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Credential |
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Telephone | 404-501-5025
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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 |
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License Number State |
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