Organization
SOUTHSIDE MEDICAL CENTER, INC.
Active
Other names
Southside Medical Center School Based Health Center at Kipp Vision
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDIO AZZARITI CPA (CFO)
(404) 564-7009
Entity
Organization
Contact information
Practice address
660 MCWILLIAMS RD SE, ATLANTA, GA 30315-7544
(678) 974-8148
(404) 688-2962
Mailing address
PO BOX 6687, ATLANTA, GA 30315-0687
(404) 688-1350
(404) 688-2962
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
10/13/2021
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