DECATUR HEALTH RESOURCES INC. NPI 1114928926

NPI Information

NPI: 1114928926
Provider Name: DECATUR HEALTH RESOURCES, INC.

Doing Business As: DEKALB MEDICAL AT DECATUR/DECATUR HOSPITAL

Classification: Long Term Care Hospital - 282E00000X
Entity Type: Organization

Address:
450 N CANDLER ST
DECATUR, GA
ZIP 30030
Phone: (404) 501-7534
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DECATUR HEALTH RESOURCES, INC. is a long term care hospital in Decatur, GA. The provider is long-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or chronic conditions. DECATUR HEALTH RESOURCES, INC. NPI is 1114928926. The provider is registered as an organization entity type.
The provider Is Doing Business As Dekalb Medical At Decatur/decatur Hospital.

The provider's business location address is:

450 N CANDLER ST
DECATUR, GA
ZIP 30030-626
Phone: (404) 501-7534
Fax: (404) 501-5811

The provider's authorized official is Ava E Daunt-samford .
The authorized official title is Vp/cfo and has the following contact phone number (404) 501-5025.

The CLIA number assigned to this NPI record is 11D1092805 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/2/2005 and was last updated on 3/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282E00000X	Long Term Care Hospital		044-475	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000000525A	MEDICAID	GEORGIA
2	001825	OTHER	GEORGIA	BCBS PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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