Provider Demographics
NPI:1497166847
Name:EMORY HEALTHCARE AT COCA COLA
Entity Type:Organization
Organization Name:EMORY HEALTHCARE AT COCA COLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-778-7550
Mailing Address - Street 1:101 W PONCE DE LEON AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2542
Mailing Address - Country:US
Mailing Address - Phone:404-778-7552
Mailing Address - Fax:
Practice Address - Street 1:1 COCA COLA PLZ NW
Practice Address - Street 2:CCP 1DO2
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-2420
Practice Address - Country:US
Practice Address - Phone:404-676-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMORY HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care