Organization
GRADY MEMORIAL HOSPITAL CORPORATION
Active
Other names
Grady Behavioral Health Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VALAURA HALLMAN (DIRECTOR PHARMACY ADMINISTRATI)
(404) 616-3576
Entity
Organization
Contact information
Practice address
10 PARK PLACE, ATLANTA, GA 30303
(404) 616-0888
(404) 616-0899
Mailing address
PO BOX 26041, 80 JESSE HILL JR DRIVE, ATLANTA, GA 30303-0001
(404) 616-3576
(404) 616-6070
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127124A
—
GA
01
—
2136347
PK
—
Enumeration date
08/06/2012
Last updated
02/10/2016
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