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Organization

NORTHSIDE HOSPITAL, INC.

Active
Other names
NORTHSIDE HOSPTIAL PHARMACY AT MEDICAL TOWER
Organization subpart
No

Provider details

NPI number
Authorized official
JUDY GARDNER PHARMD (DIRECTOR)
(404) 851-6793
Entity
Organization

Contact information

Practice address
5670 PEACHTREE DUNWOODY RD, SUITE 810, ATLANTA, GA 30342-1699
(404) 851-6310
(404) 851-6386
Mailing address
5670 PEACHTREE DUNWOODY RD, SUITE 810, ATLANTA, GA 30342-1699
(404) 851-6310
(404) 851-6386

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008997
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2016153
PK
Enumeration date
11/30/2005
Last updated
09/14/2016
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