Organization
FULTON DEKALB HOSPITAL AUTHORITY
Active
Other names
GRADY HEALTH SYSTEM
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID C MAKKERS SR. (DIRECTOR OF MANAGED CARE)
(404) 616-6695
Entity
Organization
Contact information
Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-6695
(404) 616-3297
Mailing address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3050
(404) 616-6695
(404) 616-3297
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
060069
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00410825A
—
GA
Enumeration date
07/19/2007
Last updated
06/09/2008
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