Grady Health System
General Acute Care Hospital, Critical Access in Fayetteville, GA. Organization (NPI-2).
NPI number1013211564
StatusActive
Last updated in NPPESDec 26, 2010
Details
- NPI
- 1013211564
- Entity type
- Organization (NPI-2)
- Legal business name
- Grady Health System
- Organization subpart
- No
- Enumeration date
- Dec 26, 2010
- Last updated
- Dec 26, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 282NC0060X | General Acute Care Hospital, Critical Access | 161834 | GA | Yes |
Practice location
180 Victoria DrFayetteville, GA 30214-1163
Phone 404-379-7052
Mailing address
180 Victoria DrFayetteville, GA 30214-1163
Phone 404-379-7052
Authorized official
Latoya Booth Wise
Anesthetist
4043797052
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