NPIMap

Organization Active NPI

Grady Memorial Hospital Corporation

  • Community/Retail Pharmacy
  • Atlanta, GA
National Provider Identifier
1619982261
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
004189 Issued in GA
Legal business name
GRADY MEMORIAL HOSPITAL CORPORATION
Practice address
1247 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6657
Phone
(404) 616-9951
Fax
(404) 616-1184
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
Valaura Hallman, RPH
Title
Director of Pharmacy Administration
Phone
(404) 616-3576

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 004189 GA Primary

Addresses

Primary practice location

1247 Donald Lee Hollowell Pkwy NW
Atlanta, GA 30318-6657

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
937307FMedicaidGA
2131380OtherPK

Other names 1

  • Asa Yancey Health Center Pharmacy Doing business as

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": "1619982261",
    "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": "1247 DONALD LEE HOLLOWELL PKWY NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303186657",
            "telephone_number": "404-616-9951",
            "fax_number": "404-616-1184"
        }
    ],
    "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": "VALAURA",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY ADMINISTRATION",
        "authorized_official_telephone_number": "404-616-3576",
        "authorized_official_credential": "RPH"
    },
    "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": "004189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "937307F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2131380",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Asa Yancey Health Center 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 Feb 10, 2016; 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.