Organization
NORTHSIDE HOSPITAL, INC.
Active
Other names
NORTHSIDE ALPHARETTA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY GARDNER (DIRECTOR)
(404) 851-6793
Entity
Organization
Contact information
Practice address
3400 OLD MILTON PKWY # A, SUITE 140, ALPHARETTA, GA 30005-3707
(770) 667-4023
(770) 751-7292
Mailing address
3400 OLD MILTON PKWY # A, SUITE 140, ALPHARETTA, GA 30005-3707
(770) 667-4023
(770) 751-7292
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE007668
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018667
PK
—
Enumeration date
07/19/2005
Last updated
06/17/2016
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