Organization
SOUTHSIDE MEDICAL CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDIO AZZARITI (CFO)
(404) 564-7009
Entity
Organization
Contact information
Practice address
1030 OLD PEACHTREE RD NW STE 402, LAWRENCEVILLE, GA 30043-3308
(770) 495-6222
(770) 495-9959
Mailing address
1046 RIDGE AVE SW, ATLANTA, GA 30315-1640
(404) 688-1350
(404) 688-2962
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/01/2022
Last updated
11/30/2022
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