GRADY MEMORIAL HOSPITAL CORPORATION


Address: 1575 Northside Dr Nw Bldg 400, Atlanta Tech Center Suite 450, Atlanta, GA 30318-4235
Phone: 4046160930

GRADY MEMORIAL HOSPITAL CORPORATION (NPI# 1427373224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1427373224
Entity Type Organization
Organization Name GRADY MEMORIAL HOSPITAL CORPORATION
Other Organization Name GRADY MEMORIAL HOSP CORP-CENTRAL REFILL PHCY
Practice Address 1575 Northside Dr Nw Bldg 400
Atlanta Tech Center Suite 450
Atlanta
GA 30318-4235
Mailing Address Po Box 26041
80 Jesse Hill Jr Drive Se
Atlanta
GA 30303-0001
Practice Telephone 4046160930
Practice Fax Number 4046166070
Mailing Telephone 4046163576
Mailing Fax Number 4046166070
Enumeration Date 2010-04-05
Last Update Date 2010-06-14
Authorized Official Name MS. VALAURA D. HALLMAN (DIRECTOR PHARMACY ADMINISTRATION)
Authorized Official Telephone 4046163576
Authorized Official Credential RPH
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
PHRE009648 GA Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP 1159652 01
GA 556337752A 05

Other Provider/Organization Names

Other Name Type Code
Grady Memorial Hosp Corp-Central Refill Phcy Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1124598362 Grady Memorial Hospital Corporation Pharmacy 80 Jesse Hill Jr Dr Se Rm 10b-043, Atlanta, GA 30303-3031 2018-11-30
1396025367 Grady Memorial Hospital Corporation Pharmacy 80 Jesse Hill Jr Dr Se Rm Gf, Atlanta, GA 30303-3031 2011-08-23
1891966578 Grady Memorial Hospital Corporation Ambulance 80 Jesse Hill Jr Drive Se, Box 26042, Atlanta, GA 30303-3050 2008-03-20
1437255395 Grady Memorial Hospital Corporation Skilled Nursing Facility 2800 Springdale Rd Sw, Atlanta, GA 30315-7802 2006-09-16
1083629638 Grady Memorial Hospital Corporation Pharmacy 341 Ponce De Leon Ave Ne Rm 110, Atlanta, GA 30308-2012 2006-07-30
1205872223 Grady Memorial Hospital Corporation Pharmacy 48-50 Coca Cola Place, Atlanta, GA 30303-3050 2006-06-20
1992799050 Grady Memorial Hospital Corporation Ambulance 80 Jesse Hill Jr Dr, Se, Atlanta, GA 30303-3050 2005-09-06
1649765686 Grady Memorial Hospital Corporation Clinic/Center 3896 Princeton Lakes Way, Atlanta, GA 30331 2018-06-22
1316294713 Grady Memorial Hospital Corporation Pharmacy 10 Park Place, Atlanta, GA 30303 2012-08-06
1063726339 Grady Memorial Hospital Corporation Ambulance 80 Jesse Hill Jr Dr Se, Box 26042, Atlanta, GA 30303-3031 2010-07-29

Office Location

Street Address 1575 NORTHSIDE DR NW BLDG 400
ATLANTA TECH CENTER SUITE 450
City ATLANTA
State GA
Zip Code 30318-4235

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1124597646 Cindy Denise Oden Registered Nurse 1903 Drew Dr Nw, Apt 2200, Atlanta, GA 30318 2018-11-14
1558838052 Amanda Renee Wilson Social Worker 2118 Adams Overlook Nw, Atlanta, GA 30318 2018-11-01
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Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

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1043817208 Mlk Pharmacy2.0 Pharmacy 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 2020-10-01
1407492119 Capsule Atlanta LLC Pharmacy 867 Peachtree St Ne Ste 102, Atlanta, GA 30308-1380 2019-11-18
1861978793 Uhs of Peachford Lp Pharmacy 2150 Peachford Rd Ste D, Atlanta, GA 30338 2018-07-13
1497262778 Champions Pharmacy Pharmacy 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 2018-01-08
1912357641 Headland Pharmacy LLC Pharmacy 2973 Headland Drive, Suite B, Atlanta, GA 30331 2016-06-14
1285022277 Express Food & Pharmacy Investment LLC Pharmacy 2111 Campbellton Rd Sw, Atlanta, GA 30311-4605 2014-12-30
1881024479 Camp Creek Village Pharmacy Inc. Pharmacy 3220 Butner Rd Sw Suite #130, Atlanta, GA 30331 2013-11-18
1487093662 Pharm Holdings Pharmacy 102 E Allday St, Atlanta, TX 75551-2305 2013-06-20
1255676326 Eastlake Pharmacy Inc Pharmacy 1308 Glenwood Ave Se, Atlanta, GA 30316-2077 2012-11-30
1689918468 Wal-mart Stores East Lp Pharmacy 835 Martin Luther King Jr Dr Nw, Atlanta, GA 30314-3644 2012-11-19
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Competitor

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City ATLANTA
Zip Code 30318

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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