Organization
NORTHSIDE HOSPITAL, INC.
Active
Other names
The Pharmacy Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY GARDNER (PHARMACY DIRECTOR)
(404) 851-6793
Entity
Organization
Contact information
Practice address
308 COLISEUM DR, MACON, GA 31217-3865
(478) 741-8599
(478) 741-8598
Mailing address
PHARMACY LOCK BOX, PO BOX 935685, ATLANTA, GA 31193-0001
(404) 851-2368
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008936
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138816
PK
—
Enumeration date
03/21/2006
Last updated
01/20/2016
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