# NORTHSIDE HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diagnostic Clinic Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417391194
- **Authorized official:** AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (404) 851-6968

## Contact information

- **Practice address:** 1240 JESSE JEWELL PKWY SE STE 550, GAINESVILLE, GA 30501-3863
- **Practice address phone:** (678) 450-7855
- **Mailing address:** 1000 JOHNSON FY RD NE, ATLANTA, GA 30342-1606
- **Mailing address phone:** (404) 851-6378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE009913 | GA | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/24/2013
- **Last updated:** 07/02/2026