Organization
NORTHSIDE HOSPITAL
Active
Other names
Northside Forsyth Home Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAE LYNN BENTON RPH (DIRECTOR OF PHARMACY)
(770) 844-3291
Entity
Organization
Contact information
Practice address
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041-7659
(770) 844-3396
(770) 844-3397
Mailing address
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041-7659
(770) 844-3396
(770) 844-3397
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE007472
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1151404
NABP AKA NCPDP#
GA
Enumeration date
07/14/2005
Last updated
08/22/2020
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