# MARIETTA NORTHSIDE HOSPITAL SERVICES CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MARIETTA SPECIALTY PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861123580
- **Authorized official:** JOOMI LEE MANAGER (MANAGER)
- **Authorized official phone:** (404) 721-2432

## Contact information

- **Practice address:** 4800 OLDE TOWNE PKWY STE 120, MARIETTA, GA 30068-4378
- **Practice address phone:** (404) 721-2432
- **Practice address fax:** (717) 307-3540
- **Mailing address:** 4800 OLDE TOWNE PKWY STE 120, MARIETTA, GA 30068-4378
- **Mailing address phone:** (404) 721-2432

## Taxonomy

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

## Other

- **Enumeration date:** 06/22/2022
- **Last updated:** 07/08/2026