Organization
GWINNETT HOSPITAL SYSTEM, INC.
Active
Other names
SummitRidge Center for Psychiatry and Addiction Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS Y MCBRIDE III (SR. VP., CHIEF FINANCIAL OFFICER)
(678) 442-4308
Entity
Organization
Contact information
Practice address
250 SCENIC HWY, LAWRENCEVILLE, GA 30045-5675
(678) 442-5622
(770) 339-3459
Mailing address
PO BOX 1190, LAWRENCEVILLE, GA 30046-1190
(678) 442-5622
(770) 339-3459
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
067-460
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000294A
—
GA
Enumeration date
07/03/2006
Last updated
07/26/2007
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