Organization
NORTHLAKE MEDICAL CENTER LLC
Active
Other names
Northlake Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN SATTERFIELD (CFO)
(770) 270-3010
Entity
Organization
Contact information
Practice address
1455 MONTREAL RD, TUCKER, GA 30084-8100
(770) 270-3000
(770) 270-3199
Mailing address
1455 MONTREAL RD, TUCKER, GA 30084-8100
(770) 270-3000
(770) 270-3199
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000547A
—
GA
05
—
010110491
—
VA
05
—
037132200
—
DC
05
—
10025106700
—
NE
05
—
10809A
—
SC
01
—
158331700
DEPT OF LABOR
—
05
—
1757811
—
LA
05
—
200179210A
—
IN
05
—
2064377
—
NY
05
—
2543117
—
OH
05
—
3026168
—
WA
05
—
304783690
—
MI
01
—
3119396
BLUECARE
TN
01
—
3566
BLUE CROSS
GA
05
—
410333500
—
MD
01
—
50004977
PASSPORT
KY
05
—
81479600
—
WI
05
—
883448
—
AZ
05
—
912980400
—
FL
05
—
EMO0033N
—
AL
05
—
OP10033
—
RI
Enumeration date
05/22/2006
Last updated
12/05/2008
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