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General NPI Number Information
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NPI Number | 1649224692
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Entity Type | Organization
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Legal Business Name | EASTSIDE MEDICAL CENTER, LLC
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 1700 MEDICAL WAY
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City | SNELLVILLE
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State | GA
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Zip | 30078-2195
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Country | US
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Telephone | 770-979-0200
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Fax | 770-736-2395
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Provider Business Mailing Address
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Address Line | 1700 MEDICAL WAY
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City | SNELLVILLE
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State | GA
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Zip | 30078-2195
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Country | US
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Telephone | 770-979-0200
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Fax | 770-736-2395
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Authorized Official
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Title or Position | CFO
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Name | AMY N. WHEELER
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Credential |
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Telephone | 770-736-2420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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