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General NPI Number Information
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NPI Number | 1184394058
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Entity Type | Organization
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Legal Business Name | NORTHSIDE HOSPITAL, INC.
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 1110 W PEACHTREE STREET NW SUITE 340
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City | ATLANTA
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State | GA
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Zip | 30309-3609
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Country | US
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Telephone | 678-792-4110
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Fax | 404-343-4635
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Provider Business Mailing Address
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Address Line | 1000 JOHNSON FERRY RD NE
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City | ATLANTA
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State | GA
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Zip | 30342
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Country | US
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Telephone | 404-851-8000
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Fax | 770-393-0835
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Authorized Official
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Title or Position | SYSTEM DIRECTOR, PHARMACEUTICAL SER
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Name | MS. JUDY GARDNER
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Credential |
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Telephone | 404-851-6793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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