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Organization

GWINNETT HOSPITAL SYSTEM GME, LLC

Active
Parent organization
NORTHSIDE HOSPITAL, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHSIDE HOSPITAL, INC
Authorized official
MR. JORGE HERNANDEZ (VP ADMIN; CCO)
(404) 851-6378
Entity
Organization

Contact information

Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(855) 709-4535
Mailing address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1611
(404) 851-6378

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207V00000X
Obstetrics & Gynecology Physician

Other

Enumeration date
02/25/2015
Last updated
06/02/2025
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