Provider Demographics
NPI:1003058728
Name:PIEDMONT HOSPITAL
Entity Type:Organization
Organization Name:PIEDMONT HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GAMMA KNIFE UNIT RN
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SALOME
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-605-1935
Mailing Address - Street 1:1968 PEACHTREE RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1281
Mailing Address - Country:US
Mailing Address - Phone:404-605-1935
Mailing Address - Fax:404-605-2934
Practice Address - Street 1:95 COLLIER RD
Practice Address - Street 2:GAMMA KNIFE UNIT
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-605-1935
Practice Address - Fax:404-605-2934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA282N0000X282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital