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General NPI Number Information
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NPI Number | 1649765686
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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 | 06/22/2018
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 3896 PRINCETON LAKES WAY
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City | ATLANTA
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State | GA
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Zip | 30331
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Country | US
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Telephone | 404-616-8880
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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 # 26042
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City | ATLANTA
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State | GA
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Zip | 30303-3031
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Country | US
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Telephone | 404-616-8880
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Fax | 404-489-6920
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE
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Name | TAMARA ANNE NILMEIER
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Credential |
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Telephone | 404-616-8880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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