NPIMap

Organization Active NPI

Grady Memorial Hospital Corporation

Doing business as Grady Correll Retail Pharmacy

  • Community/Retail Pharmacy
  • Atlanta, GA
National Provider Identifier
1396025367
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GRADY MEMORIAL HOSPITAL CORPORATION
Doing business as
Grady Correll Retail Pharmacy
Practice address
80 Gilmer St Room G300
Atlanta, GA 30303
Phone
(404) 616-3190
Fax
(404) 616-6070
NPI assigned
Aug 23, 2011
Last updated
Jun 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Authorized official

Name
Valaura Hallman
Title
Director Pharmacy Administrati
Phone
(404) 616-3576

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

80 Gilmer St Room G300
Atlanta, GA 30303

Mailing address

PO Box 26041
80 Jesse Hill Jr Drive
Atlanta, GA 30303-0001
Phone (404) 616-3576

Other identifiers 1

IdentifierTypeStateIssuer
2132235OtherPK

Other names 1

  • Grady Correll Retail Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grady Memorial Hospital15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

80 Jesse Hill Jr Dr SE
Rm Gf
Atlanta, GA 30303

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1396025367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26041",
            "address_2": "80 JESSE HILL JR DRIVE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303030001",
            "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": "80 GILMER ST ROOM G300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30303",
            "telephone_number": "404-616-3190",
            "fax_number": "404-616-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "HALLMAN",
        "authorized_official_first_name": "VALAURA",
        "authorized_official_title_or_position": "DIRECTOR PHARMACY ADMINISTRATI",
        "authorized_official_telephone_number": "404-616-3576"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grady Correll Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grady Correll Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.