Organization
NORTHSIDE HOSPITAL PHARMACY AT MERIDIAN MARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN HORTON JACKSON (PHARMACIST)
(404) 459-1740
Entity
Organization
Contact information
Practice address
5445 MERIDIAN MARKS RD NE, STE 190, ATLANTA, GA 30342-4763
(404) 459-1740
(404) 459-1745
Mailing address
5445 MERIDIAN MARKS RD NE, STE 190, ATLANTA, GA 30342-4763
(404) 459-1740
(404) 459-1745
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHRE008289
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00821796A
—
GA
Enumeration date
09/20/2005
Last updated
08/22/2020
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