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General NPI Number Information
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NPI Number | 1639178213
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Entity Type | Organization
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Legal Business Name | NORTHSIDE HOSPITAL HOMECARE PHARMACY
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 1000 JOHNSON FERRY RD NE HOMECARE PHARMACY
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City | ATLANTA
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State | GA
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Zip | 30342-1606
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Country | US
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Telephone | 404-851-8897
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Fax | 404-303-3323
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Provider Business Mailing Address
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Address Line | 1000 JOHNSON FERRY RD NE HOMECARE PHARMACY
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City | ATLANTA
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State | GA
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Zip | 30342-1606
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Country | US
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Telephone | 404-851-8897
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Fax | 404-303-3323
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | MRS. 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 006234
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License Number State | GA
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