Organization
NORTHSIDE HOSPITAL, INC.
Active
Other names
Suburban Oncology Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE J. HERNANDEZ (CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
631 PROFESSIONAL DR STE 450, LAWRENCEVILLE, GA 30046-3370
(678) 533-1559
Mailing address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1606
(404) 851-6378
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/20/2021
Last updated
08/06/2021
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