# ATLANTA VA MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306874219
- **Authorized official:** MS. MELODYE MARGUERITE JACOBS RN (CHARGE NURSE)
- **Authorized official phone:** (404) 321-6111

## Contact information

- **Practice address:** 1670 CLAIRMONT RD, DECATUR, GA 30033-4004
- **Practice address phone:** (404) 321-6111
- **Practice address fax:** (404) 329-4632
- **Mailing address:** 630 CREEKVIEW BLVD, COVINGTON, GA 30016-3085
- **Mailing address phone:** (770) 385-7377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP2201X | Ambulatory Care Registered Nurse | R109830 | GA | Yes |

## Other

- **Enumeration date:** 06/29/2006
- **Last updated:** 08/22/2020