Organization
NSH CANCER INSTITUTE PROFESSIONAL SERVICES A LLC
Active
Parent organization
NORTHSIDE HOSPITAL, INC.
Other names
NSH CIPS A
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
5670 PEACHTREE DUNWOODY RD NE, SUITE 1100, ATLANTA, GA 30342-1699
(404) 851-2300
Mailing address
1100 JOHNSON FERRY RD NE, CENTERPOINTE 1, SUITE 510, ATLANTA, GA 30342-1709
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
333600000X
Pharmacy
—
—
Other
Enumeration date
09/28/2012
Last updated
02/06/2013
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