# NORTHSIDE HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northside Hospital Gwinnett Outpatient Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801417480
- **Authorized official:** AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (404) 851-6968

## Contact information

- **Practice address:** 1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
- **Practice address phone:** (678) 312-4233
- **Mailing address:** 1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1606
- **Mailing address phone:** (404) 851-8000

## Taxonomy

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

## Other

- **Enumeration date:** 05/05/2020
- **Last updated:** 06/12/2026