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 OD ADMIN SERVICES AND CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
134 MOUNTAINSIDE VILLAGE PKWY, BLDG. 400, SUITE 100, JASPER, GA 30143-8694
(706) 253-3100
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/19/2012
Last updated
01/16/2013
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