Provider Demographics
NPI:1730133786
Name:EHCA DUNWOODY, LLC
Entity type:Organization
Organization Name:EHCA DUNWOODY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SATTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-421-7909
Mailing Address - Street 1:4575 N SHALLOWFORD RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6445
Mailing Address - Country:US
Mailing Address - Phone:770-454-2000
Mailing Address - Fax:770-454-4279
Practice Address - Street 1:4575 N SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6445
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:2006-05-22
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
158334500OtherDEPT OF LABOR
TX176309601Medicaid
HI555485Medicaid
NY16567755Medicaid
3568OtherBLUE CROSS
AZ762105Medicaid
GA00001669AMedicaid
VA010120811Medicaid
LA1707031Medicaid
OH2498560Medicaid
7253OtherBLUE CARE
NJ9067809Medicaid
RI110172Medicaid
IN200377230AMedicaid
FL912086600Medicaid
ALEMO0172NMedicaid
PA0019093780002Medicaid
TN0110172Medicaid
SC10741AMedicaid
CAXHSP33612Medicaid
MD407052600Medicaid
HI555485Medicaid
IL=========001Medicaid