Southside Healthcare

LBN: Southside Medical Center, Inc.
Southside Healthcare is an health care organization with primary practice located at 1046 Ridge Ave Sw , Atlanta GA 30315-1640. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Southside Medical Center, Inc. can be contacted via phone (404) 688-1350, or through Azzariti, Claudio via phone (404) 564-7009.

Contact Information

Primary practice address
1046 Ridge Ave Sw Atlanta GA 30315-1640
Phone: (404) 688-1350
Fax: (404) 688-2962
Website:
Map and Directions
Authorized official contact:
Name: Azzariti, Claudio
Phone: (404) 564-7009

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1063627610
LBN Legal business name Southside Medical Center, Inc.
DBA Doing business as Southside Healthcare
Authorized official Azzariti, Claudio
Entity Organization
Organization subpart 1 No
Enumeration date May 14th, 2007
Last updated Aug 22nd, 2020 - 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 1063627610 NPPES
Georgia MEDICAID 00021502A

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