Provider Demographics
NPI:1679632137
Name:EHCA JOHNS CREEK, LLC
Entity Type:Organization
Organization Name:EHCA JOHNS CREEK, LLC
Other - Org Name:EMORY JOHNS CREEK 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:PO BOX 277409
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7409
Mailing Address - Country:US
Mailing Address - Phone:770-454-2001
Mailing Address - Fax:770-454-4279
Practice Address - Street 1:6325 HOSPITAL PARKWAY
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-5775
Practice Address - Country:US
Practice Address - Phone:770-454-2000
Practice Address - Fax:770-454-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
110230Medicare Oscar/Certification