=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730133786
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EHCA DUNWOODY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2006
-----------------------------------------------------
Last Update Date | 12/05/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4575 N SHALLOWFORD RD
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30338-6445
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-454-2000
-----------------------------------------------------
Fax | 770-454-4279
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4575 N SHALLOWFORD RD
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30338-6445
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-454-2000
-----------------------------------------------------
Fax | 770-454-4279
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | SUSAN SATTERFIELD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 678-421-7909
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------