1972758506 NPI number — EMORY HEALTHCARE WINSHIP CANCER INSTITUTE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972758506 NPI number — EMORY HEALTHCARE WINSHIP CANCER INSTITUTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMORY HEALTHCARE WINSHIP CANCER INSTITUTE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972758506
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1365C CLIFTON RD NE
Provider Second Line Business Mailing Address:
SUITE C2056
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30322-1013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-778-1900
Provider Business Mailing Address Fax Number:
404-778-5676

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1365C CLIFTON RD NE
Provider Second Line Business Practice Location Address:
SUITE C2056
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30322-1013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-778-1900
Provider Business Practice Location Address Fax Number:
404-778-5676
Provider Enumeration Date:
11/24/2008

Additional Information

Authorized Official

Authorized Official Last Name:
MCDANIEL
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
Authorized Official Title or Position:
OMCOLOGY NURSE MANAGER WINSHIP
Authorized Official Telephone Number:
404-778-3954

Provider Taxonomy Codes

  • Taxonomy code: 261QX0200X , with the licence number:  RN167522 NP , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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