Provider Demographics
NPI:1992018345
Name:EMORY HEALTHCARE
Entity Type:Organization
Organization Name:EMORY HEALTHCARE
Other - Org Name:EMORY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:COORDINATOR OF PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CPCS
Authorized Official - Phone:404-778-3914
Mailing Address - Street 1:3282 WELMINGHAM DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-6264
Mailing Address - Country:US
Mailing Address - Phone:404-349-7210
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:30308-2208
Practice Address - Country:US
Practice Address - Phone:404-686-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA179344282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital