NPIMap

Organization Active NPI

Grady Memorial Hospital Corporation

Doing business as East Point Grady Health Center Pharmacy

  • Community/Retail Pharmacy
  • East Point, GA
National Provider Identifier
1174538722
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
004658 Issued in GA
Legal business name
GRADY MEMORIAL HOSPITAL CORPORATION
Doing business as
East Point Grady Health Center Pharmacy
Practice address
1595 Cleveland Ave
East Point, GA 30344-3200
Phone
(404) 616-9231
Fax
(404) 768-6455
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Val Hallman
Title
Director of Pharmacy Administration
Phone
(404) 616-3576

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 004658 GA Primary

Addresses

Primary practice location

1595 Cleveland Ave
East Point, GA 30344-3200

Mailing address

Pharmacy Administration-26041
80 Jesse Hill Jr Drive
Atlanta, GA 30303
Phone (404) 616-3576

Other identifiers 2

IdentifierTypeStateIssuer
2131149OtherPK
937307IMedicaidGA

Other names 1

  • East Point Grady Health Center Pharmacy Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1001411Grady Health System East Point1595 West Cleveland Avenue, East Point, GA 30344AccreditationSep 16, 2026

National Provider Directory

National Provider Directory
Tax ID family
Grady Memorial Hospital Corporation12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1174538722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PHARMACY ADMINISTRATION-26041",
            "address_2": "80 JESSE HILL JR DRIVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30303",
            "telephone_number": "404-616-3576",
            "fax_number": "404-616-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 CLEVELAND AVE",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443200",
            "telephone_number": "404-616-9231",
            "fax_number": "404-768-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "HALLMAN",
        "authorized_official_first_name": "VAL",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY ADMINISTRATION",
        "authorized_official_telephone_number": "404-616-3576"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "004658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131149",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "937307I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Point Grady Health Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Point, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.