# NORTHWEST GEORGIA ONCOLOGY CENTERS, P.C

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHWEST GEORGIA ONCOLOGY CENTERS,P.C
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1821275629
- **Legal business name:** NORTHWEST GEORGIA ONCOLOGY CENTERS,P.C
- **Authorized official:** DR. BRUCE J GOULD MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (770) 281-5000

## Contact information

- **Practice address:** 340 KENNESTONE HOSPITAL BLVD, SUITE 200, MARIETTA, GA 30060-1152
- **Practice address phone:** (770) 281-5115
- **Practice address fax:** (678) 581-7111
- **Mailing address:** 531 ROSELANE ST NW, SUITE 710, MARIETTA, GA 30060-6913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE009445 | GA | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 01/24/2008
- **Last updated:** 02/26/2008