Organization
NORTHSIDE HOSPITAL, INC
Active
Other names
Northside Hospital Home Care Pharmacy - Cherokee
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY GARDNER (DIRECTOR)
(404) 851-6793
Entity
Organization
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1250
(770) 224-1251
Mailing address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1250
(770) 224-1251
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010431
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2175804
PK
—
Enumeration date
02/19/2018
Last updated
02/19/2018
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