Organization
EASTSIDE MEDICAL CENTER, LLC
Active
Other names
Piedmont Eastside Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C CROSS (VP GOVERNMENT REIMBURSEMENT)
(470) 271-3401
Entity
Organization
Contact information
Practice address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(770) 979-0200
(770) 736-2395
Mailing address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(770) 979-0200
(770) 736-2395
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00190088A
—
GA
05
—
0067598
—
NJ
05
—
0110192
—
TN
05
—
036540100
—
DC
05
—
071850401
—
TX
05
—
1010484
—
MA
05
—
119513
—
AZ
05
—
143405
—
SC
01
—
1526531
GATEWAY MEDICAID HMO
—
05
—
157505105
—
AR
01
—
158328200
DEPT OF LABOR
—
05
—
1633343
—
NY
05
—
200225640A
—
IN
05
—
30000595
—
PA
05
—
3022050
—
WA
05
—
308068059
—
MI
01
—
3564
BLUE CROSS
—
01
—
4001267
BLUE CARE
—
05
—
406635900
—
MD
05
—
421810000
—
ME
05
—
50002177
—
KY
05
—
82092
—
NY
05
—
82176800
—
WI
05
—
909638800
—
FL
05
—
HOS0192N
—
AL
05
—
XHSP33294
—
CA
Enumeration date
05/19/2006
Last updated
02/26/2024
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