Organization
GWINNETT HOSPITAL SYSTEM TCCC LLC
Active
Parent organization
GWINNNETT HOSPITAL SYSTEM, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
GWINNNETT HOSPITAL SYSTEM, INC.
Authorized official
MR. THOMAS Y MCBRIDE III (EXECUTIVE VICE PRESIDENT/CFO)
(678) 312-4308
Entity
Organization
Contact information
Practice address
631 PROFESSIONAL DR STE 450, LAWRENCEVILLE, GA 30046-3370
(770) 963-8030
Mailing address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-5527
(770) 339-3459
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
—
—
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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