Organization
SOUTHSIDE MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAUDIO AZZARITI MBA, CPA (CHIEF FINANCIAL OFFICER)
(404) 688-1350
Entity
Organization
Contact information
Practice address
1514 CLEVELAND AVE STE 205, EAST POINT, GA 30344-6965
(678) 510-0827
(678) 510-0826
Mailing address
1046 RIDGE AVE SW, ATLANTA, GA 30315-1640
(404) 688-1350
(404) 564-0431
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
044293H
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00064336A
—
GA
Enumeration date
07/25/2006
Last updated
06/10/2010
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