Organization
NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC
Active
Parent organization
NORTHSIDE HOSPITAL, INC.
Other names
NSH CIPS G
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHSIDE HOSPITAL, INC.
Authorized official
JORGE HERNANDEZ (VP OF ADMIN SERVICES AND CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
1100 JOHNSON FERRY RD NE, SUITE 600, SANDY SPRINGS, GA 30342-1709
(404) 256-4777
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
=========
TAX ID
GA
Enumeration date
09/27/2012
Last updated
06/25/2025
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