Organization
NORTHSIDE HOSPITAL, INC.
Active
Other names
Atlanta Cancer Care
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY GARDNER (DIRECTOR, PHARMACY)
(404) 851-6793
Entity
Organization
Contact information
Practice address
5670 PEACHTREE DUNWOODY RD STE 1100, ATLANTA, GA 30342-4795
(404) 851-2368
(404) 851-2009
Mailing address
NSH CANCER INST PRO SERVICES A LLC, PO BOX 935689, ATLANTA, GA 31193-0001
(404) 851-2368
(404) 851-2009
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE08919
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138815
PK
—
Enumeration date
07/26/2006
Last updated
01/20/2016
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