# NSH CANCER INSTITUTE PROFESSIONAL SERVICES A,LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHSIDE HOSPITAL
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568712594
- **Legal business name:** NORTHSIDE HOSPITAL
- **Authorized official:** JORGE HERNANDEZ (VP OF ADMIN SERVICES AND CCO)
- **Authorized official phone:** (404) 851-6378

## Contact information

- **Practice address:** 5670 PEACHTREE DUNWOODY RD NE STE 1100, ATLANTA, GA 30342-4795
- **Practice address phone:** (404) 851-6378
- **Mailing address:** 1100 JOHNSON FERRY RD NE, SUITE 500, ATLANTA, GA 30342-1709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/18/2012
- **Last updated:** 09/28/2012