Provider Demographics
NPI:1144203563
Name:CRAWFORD LONG HOSPITAL
Entity Type:Organization
Organization Name:CRAWFORD LONG HOSPITAL
Other - Org Name:EMORY UNIVERSITY DBA EMORY CRAWFORD LONG HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:AVA
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAUNT-SAMFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-686-4918
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308
Mailing Address - Country:US
Mailing Address - Phone:404-686-2009
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308
Practice Address - Country:US
Practice Address - Phone:404-686-7519
Practice Address - Fax:404-686-4887
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMORY UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-21
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000000503AMedicaid
GA110078Medicare Oscar/Certification