Provider Demographics
NPI:1437136918
Name:EMORY UNIVERSITY
Entity Type:Organization
Organization Name:EMORY UNIVERSITY
Other - Org Name:EMORY UNIVERSITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/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 1:1364 CLIFTON RD NE
Mailing Address - Street 2:ROOM HB48
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1064
Mailing Address - Country:US
Mailing Address - Phone:404-686-2983
Mailing Address - Fax:404-712-5731
Practice Address - Street 1:1364 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1064
Practice Address - Country:US
Practice Address - Phone:404-686-2983
Practice Address - Fax:404-712-5731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044-049283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00000712AMedicaid
GA11S010Medicare Oscar/Certification