Organization
MEDSIDE PALLIATIVE CARE
Active
Other names
Medside
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YULIYA KORABELNIKOVA RN (CHA/ADMINISTRATOR)
(404) 633-7433
Entity
Organization
Contact information
Practice address
3384 PEACHTREE RD NE, ATLANTA, GA 30326-1181
(404) 633-7433
(888) 633-7430
Mailing address
PO BOX 190996, ATLANTA, GA 31119-0996
(404) 633-7433
(888) 633-7430
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00849527A
—
GA
01
—
060-R-0068
MEDSIDE HOME CARE AGENCY
GA
01
—
0606-245-H
STATE ID LICENSE
GA
01
—
1306858121
NPI
GA
Enumeration date
03/21/2007
Last updated
10/16/2007
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