MEDICARE: EHCA DUNWOODY, LLC

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
1	282N00000X	General Acute Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	158334500	OTHER	DEPT OF LABOR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	3568	OTHER	BLUE CROSS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	7253	OTHER	BLUE CARE
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
19	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730133786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EHCA DUNWOODY, LLC

Provider Business Mailing Address
First Line	:	4575 N SHALLOWFORD RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-6445
Country	:	US
Telephone Number	:	770-454-2000
Fax Number	:	770-454-4279

Provider Business Practice Location Address
First Line	:	4575 N SHALLOWFORD RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-6445
Country	:	US
Telephone Number	:	770-454-2000
Fax Number	:	770-454-4279

Authorized Official
Title or Position	:	CFO
Name	:	SUSAN SATTERFIELD
Credential	:
Telephone Number	:	678-421-7909

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	12/05/2008

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