Provider Demographics
NPI:1528116993
Name:ALDREDGE HEALTH CENTER
Entity type:Organization
Organization Name:ALDREDGE HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:404-730-1202
Mailing Address - Street 1:99 JESSE HILL JR DRIVE RM 402
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:99 JESSE HILL JR DRIVE RM 402
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-730-1485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FULTON COUNTY DEPT HEALTH&WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-08
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000541665AMedicaid
GA00457795HMedicaid
GA000051884AMedicaid
GA000698662UMedicaid
GA00457773BMedicaid
GA00457795FMedicaid
GA000443979AMedicaid