Provider Demographics
NPI:1033135959
Name:WELLSTAR NORTH FULTON HOSPITAL, INC
Entity Type:Organization
Organization Name:WELLSTAR NORTH FULTON HOSPITAL, INC
Other - Org Name:NORTH FULTON HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP & CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUDZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-644-0012
Mailing Address - Street 1:1800 PARKWAY PL SE STE 500
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8237
Mailing Address - Country:US
Mailing Address - Phone:470-956-4981
Mailing Address - Fax:770-999-2489
Practice Address - Street 1:3000 HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4915
Practice Address - Country:US
Practice Address - Phone:770-751-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH FULTON REGIONAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-14
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-357273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
11-T198Medicare ID - Type UnspecifiedREHAB