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General NPI Number Information
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NPI Number | 1497166847
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Entity Type | Organization
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Legal Business Name | EMORY HEALTHCARE AT COCA COLA
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 1 COCA COLA PLZ NW CCP 1DO2
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City | ATLANTA
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State | GA
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Zip | 30313-2420
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Country | US
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Telephone | 404-676-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 101 W PONCE DE LEON AVE
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City | DECATUR
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State | GA
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Zip | 30030-2542
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Country | US
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Telephone | 404-778-7552
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MAUREEN HALDEMAN
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Credential |
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Telephone | 404-778-7550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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