Organization
NSH CANCER INSTITUTE PROFESSIONAL SERVICES A LLC
Active
Parent organization
NORTHSIDE HOSPITAL, INC.
Other names
NSH CIPS A
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHSIDE HOSPITAL, INC.
Authorized official
JORGE J HERNANDEZ (VP OF ADMIN SERVICES AND CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
1498 KLONDIKE RD SW, SUITE 106, CONYERS, GA 30094-5169
(770) 761-7260
Mailing address
1100 JOHNSON FERRY RD NE, CENTER POINTE I, SUITE 510, ATLANTA, GA 30342-1709
(404) 419-1159
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/18/2012
Last updated
01/23/2014
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