# NORTHLAKE MEDICAL CENTER LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Northlake Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346294303
- **Authorized official:** SUSAN SATTERFIELD (CFO)
- **Authorized official phone:** (770) 270-3010

## Contact information

- **Practice address:** 1455 MONTREAL RD, TUCKER, GA 30084-8100
- **Practice address phone:** (770) 270-3000
- **Practice address fax:** (770) 270-3199
- **Mailing address:** 1455 MONTREAL RD, TUCKER, GA 30084-8100
- **Mailing address phone:** (770) 270-3000
- **Mailing address fax:** (770) 270-3199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 12/05/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00000547A | — | GA |
| 05 | — | 010110491 | — | VA |
| 05 | — | 037132200 | — | DC |
| 05 | — | 10025106700 | — | NE |
| 05 | — | 10809A | — | SC |
| 01 | — | 158331700 | DEPT OF LABOR | — |
| 05 | — | 1757811 | — | LA |
| 05 | — | 200179210A | — | IN |
| 05 | — | 2064377 | — | NY |
| 05 | — | 2543117 | — | OH |
| 05 | — | 3026168 | — | WA |
| 05 | — | 304783690 | — | MI |
| 01 | — | 3119396 | BLUECARE | TN |
| 01 | — | 3566 | BLUE CROSS | GA |
| 05 | — | 410333500 | — | MD |
| 01 | — | 50004977 | PASSPORT | KY |
| 05 | — | 81479600 | — | WI |
| 05 | — | 883448 | — | AZ |
| 05 | — | 912980400 | — | FL |
| 05 | — | EMO0033N | — | AL |
| 05 | — | OP10033 | — | RI |