Northside Gwinnett Extended Care Center

LBN: Northside Hospital, Inc.
Northside Gwinnett Extended Care Center is an health care organization with primary practice located at 650 Professional Dr , Lawrenceville GA 30046-8707. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Northside Hospital, Inc. can be contacted via phone (678) 312-3000, or through Hernandez, Jorge via phone (404) 851-6378.

Contact Information

Primary practice address
650 Professional Dr Lawrenceville GA 30046-8707
Phone: (678) 312-3000
Fax: (678) 312-3065
Website:
Map and Directions
Authorized official contact:
Name: Hernandez, Jorge
Phone: (404) 851-6378

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 067-460 Georgia

Profile Details

NPI number 1396788428
LBN Legal business name Northside Hospital, Inc.
DBA Doing business as Northside Gwinnett Extended Care Center
Authorized official Hernandez, Jorge
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2006
Last updated Sep 18th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396788428 NPPES
Georgia MEDICAID 781382A

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