Organization
GRADY MEMORIAL HOSPITAL CORPORATION
Active
Other names
Asa Yancey Health Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VALAURA HALLMAN RPH (DIRECTOR OF PHARMACY ADMINISTRATION)
(404) 616-3576
Entity
Organization
Contact information
Practice address
1247 DONALD LEE HOLLOWELL PKWY NW, ATLANTA, GA 30318-6657
(404) 616-9951
(404) 616-1184
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
004189
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131380
PK
—
05
—
937307F
—
GA
Enumeration date
07/30/2006
Last updated
02/10/2016
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