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NPI Code Detail

MEDICARE: KENNESTONE HOSPITAL, INC

MEDICARE: KENNESTONE HOSPITAL, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1273Y00000XRehabilitation Hospital Unit033-548GA
2273Y00000XRehabilitation Hospital UnitGA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578553343
Entity Type Code : Organization
Provider Name (Legal Business Name) : KENNESTONE HOSPITAL, INC
Provider Business Mailing Address
First Line : 1800 PARKWAY PL SE STE 500
Second Line :
City : MARIETTA
State : GA
Zip : 30067-8237
Country : US
Telephone Number : 470-956-4981
Fax Number : 770-999-2489
Provider Business Practice Location Address
First Line : 677 CHURCH ST NE
Second Line : INPATIENT REHAB UNIT/6 WEST
City : MARIETTA
State : GA
Zip : 30060-1101
Country : US
Telephone Number : 470-644-0012
Fax Number : 770-793-7939
Authorized Official
Title or Position : EVP & CHIEF FINANCIAL OFFICER
Name : MR. ANTHONY J BUDZINSKI
Credential :
Telephone Number : 470-644-0012
Provider Enumeration Date : 10/24/2005
Last Update Date : 10/31/2024

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Directions to “KENNESTONE HOSPITAL, INC ” Practice Location

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