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General NPI Number Information
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NPI Number | 1578834008
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Entity Type | Organization
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Legal Business Name | EMORY HEALTHCARE
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-686-5500
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Fax | 404-778-4431
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Provider Business Mailing Address
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Address Line | 1365 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-686-5500
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Fax | 404-778-4431
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Authorized Official
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Title or Position | TECHNICAL DIRECTOR, INTERNAL MEDICI
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Name | MS. CICELY A ROSS
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Credential | RRT/BSN, P-S
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Telephone | 404-219-4122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | RN177619
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License Number State | GA
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