Provider Demographics
NPI:1740547033
Name:THE EMORY CLINIC
Entity type:Organization
Organization Name:THE EMORY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNT ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-778-7988
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:404-778-7988
Mailing Address - Fax:404-778-4509
Practice Address - Street 1:101 W PONCE DE LEON AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2542
Practice Address - Country:US
Practice Address - Phone:404-778-7988
Practice Address - Fax:404-778-4509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization