Organization
GRADY MEMORIAL HOSPITAL CORPORATION
Active
Other names
Grady Pratt Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHERINE CHEELEY PHARMD (EXEC DIR OF AMBULATORY PHARMACY)
(404) 616-5711
Entity
Organization
Contact information
Practice address
80 JESSE HILL JR DR SE, RM GD032, ATLANTA, GA 30303-3031
(404) 616-5080
(404) 616-4111
Mailing address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-5079
(404) 616-8663
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008430
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1159676
NCPDP
GA
05
—
517281744A
—
GA
Enumeration date
03/08/2010
Last updated
04/23/2023
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