Provider Demographics
NPI:1386165504
Name:THE EMORY CLINIC INC
Entity type:Organization
Organization Name:THE EMORY CLINIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-778-5014
Mailing Address - Street 1:2201 HENDERSON MILL RD NE STE 160
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2711
Mailing Address - Country:US
Mailing Address - Phone:404-778-5079
Mailing Address - Fax:
Practice Address - Street 1:7813 SPIVEY STATION BLVD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2900
Practice Address - Country:US
Practice Address - Phone:404-778-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMORY CLINIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-28
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical