Southside Healthcare
LBN: Southside Medical Center, Inc.
Southside Healthcare is an health care organization with primary practice located at 1100 Cleveland Ave , Atlanta GA 30344-3602. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Agencies / Community/Behavioral Health is the primary health care specialty.
Southside Medical Center, Inc. can be contacted via phone (404) 627-1385, or through Azzariti, Claudio via phone (404) 564-7009.
Contact Information
Primary practice address
1100 Cleveland Ave
Atlanta GA 30344-3602
Phone: (404) 627-1385
Fax: (404) 564-0377
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Community/Behavioral Health | 251S00000X | Georgia | |
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1174641658 |
|---|---|
| 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 | Mar 26th, 2007 |
| Last updated | Jun 11th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174641658 | NPPES |
| Georgia | Other | GRP375 | MEDICARE GROUP |
| Georgia | MEDICAID | 000041764B | MEDICARE GROUP |
| Georgia | MEDICAID | 000444056H | MEDICARE GROUP |
| Georgia | Other | 04092 | MEDICARE GROUP |
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