NPIMap

Organization Active NPI

Grady Memorial Hospital Corporation

Doing business as Grady Pratt Street Pharmacy

  • Community/Retail Pharmacy
  • Atlanta, GA
National Provider Identifier
1972826766
Registry record updated Apr 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE008430 Issued in GA
Legal business name
GRADY MEMORIAL HOSPITAL CORPORATION
Doing business as
Grady Pratt Street Pharmacy
Practice address
80 Jesse Hill Jr Dr SE
RM Gd032
Atlanta, GA 30303-3031
Phone
(404) 616-5080
Fax
(404) 616-4111
NPI assigned
Mar 8, 2010
Last updated
Apr 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2023

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

Authorized official

Name
Mary Katherine Cheeley, PHARMDNPI 1245526243
Title
Exec Dir of Ambulatory Pharmacy
Phone
(404) 616-5711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE008430 GA Primary

Addresses

Primary practice location

80 Jesse Hill Jr Dr SE
RM Gd032
Atlanta, GA 30303-3031

Mailing address

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-5079

Other identifiers 2

IdentifierTypeStateIssuer
1159676OtherGANCPDP
517281744AMedicaidGA

Other names 1

  • Grady Pratt Street Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grady Health System15 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 GD32
Atlanta, GA 30303
Phone (404) 616-5080

80 Jesse Hill Jr Dr SE
Rm GF3
Atlanta, GA 30303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682208000000",
    "number": "1972826766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-5079",
            "fax_number": "404-616-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "address_2": "RM GD032",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-5080",
            "fax_number": "404-616-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY MEMORIAL HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-08",
        "last_updated": "2023-04-23",
        "certification_date": "2023-04-23",
        "status": "A",
        "authorized_official_last_name": "CHEELEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "EXEC DIR OF AMBULATORY PHARMACY",
        "authorized_official_telephone_number": "404-616-5711",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE008430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "1159676",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "517281744A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grady Pratt Street 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 Apr 23, 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.