Organization
GRADY MEMORIAL HOSPITAL CORPORATION
Active
Other names
Grady Lee and White Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NICK MICHAUD RPH (DIRECTOR OF PHARMACY)
(404) 616-5500
Entity
Organization
Contact information
Practice address
1000 WHITE ST SW, STE 1004, ROOM 400, ATLANTA, GA 30310
(404) 616-8618
(404) 616-6070
Mailing address
PHARMACY ADMINISTRATION-26041, 80 JESSE HILL JR DRIVE, ATLANTA, GA 30303
(404) 616-3576
(404) 616-6070
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE000512
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131375
PK
—
05
—
855C
—
GA
Enumeration date
06/20/2006
Last updated
09/03/2024
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