Organization
NORTHWEST GEORGIA ONCOLOGY CENTERS, P.C
Active
Parent organization
NORTHWEST GEORGIA ONCOLOGY CENTERS,P.C
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST GEORGIA ONCOLOGY CENTERS,P.C
Authorized official
DR. BRUCE J GOULD MD (MEDICAL DIRECTOR)
(770) 281-5000
Entity
Organization
Contact information
Practice address
340 KENNESTONE HOSPITAL BLVD, SUITE 200, MARIETTA, GA 30060-1152
(770) 281-5115
(678) 581-7111
Mailing address
531 ROSELANE ST NW, SUITE 710, MARIETTA, GA 30060-6913
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009445
GA
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
01/24/2008
Last updated
02/26/2008
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