Organization
GRADY MEMORIAL HOSPITAL CORPORATION
Active
Other names
North Dekalb Health Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VALAURA HALLMAN RPH (DIRECTOR OF PHARMACY)
(404) 616-3576
Entity
Organization
Contact information
Practice address
3807 CLAIRMONT RD, CHAMBLEE, GA 30341-4911
(404) 616-3031
(404) 616-3094
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
007772
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131379
PK
—
05
—
937307B
—
GA
Enumeration date
07/30/2006
Last updated
02/10/2016
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