Organization
ATLANTA MEDICAL CENTER, INC.
Active
Other names
Atlanta Medical Center- South Campus
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM T. MOORE (CEO)
(404) 256-4000
Entity
Organization
Contact information
Practice address
1170 CLEVELAND AVE, EAST POINT, GA 30344-3615
(404) 466-1170
Mailing address
PO BOX 741252, ATLANTA, GA 30374-1252
(678) 242-2002
(678) 242-2202
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
060-598
GA
341600000X
Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00382509
—
NY
05
—
0542792
—
OH
05
—
08500709
—
MS
01
—
100054
BCBS OF GEORGIA
—
01
—
109906
COVENTRY HEALTH CARE GEOR
—
01
—
110219B000000
SECTION 1011
—
05
—
1708445
—
LA
01
—
181713800
VISTA HEALTH PLAN HMO/POS
—
05
—
300042914A
—
GA
01
—
75-2918809
TENET EMPLOYEES BENEFIT P
—
01
—
979062670
AETNA US HEALTHCARE (NATI
—
Enumeration date
07/14/2006
Last updated
03/24/2022
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