NORTHSIDE HOSPITAL, INC. (NPI# 1417391194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417391194 |
| Entity Type | Organization |
| Organization Name | NORTHSIDE HOSPITAL, INC. |
| Other Organization Name | DIAGNOSTIC CLINIC PHARMACY |
| Practice Address |
1240 Jesse Jewell Pkwy Se Ste 550 Gainesville GA 30501-3863 |
| Mailing Address |
1000 Johnson Fy Rd Ne Atlanta GA 30342-1606 |
| Practice Telephone | 6784507855 |
| Mailing Telephone | 4048516378 |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2018-10-25 |
| Authorized Official Name | JORGE J. HERNANDEZ (VP ADMIN SRVS/CCO) |
| Authorized Official Telephone | 4048516378 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE009913 | GA | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Diagnostic Clinic Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770112021 | Northside Hospital, Inc. | Durable Medical Equipment & Medical Supplies | 460 Northside Cherokee Blvd Ste 145, Canton, GA 30115-8016 | 2020-04-07 |
| 1861416562 | Northside Hospital, Inc. | Pharmacy | 5670 Peachtree Dunwoody Rd Ste 1100, Atlanta, GA 30342-4795 | 2006-07-26 |
| 1790715381 | Northside Hospital, Inc. | General Acute Care Hospital | 3620 Howell Ferry Road, Duluth, GA 30096-3223 | 2006-07-03 |
| 1134168016 | Northside Hospital, Inc. | Rehabilitation Unit | 3215 Mcclure Bridge Rd, Duluth, GA 30096-3223 | 2006-06-06 |
| 1437134970 | Northside Hospital, Inc. | General Acute Care Hospital | 650 Professional Dr, Lawrenceville, GA 30045-8707 | 2005-12-07 |
| 1679572861 | Northside Hospital, Inc. | Pharmacy | 3400 Old Milton Pkwy # A, Suite 140, Alpharetta, GA 30005-3707 | 2005-07-19 |
| 1326679150 | Northside Hospital, Inc. | Pharmacy | 1485 Jesse Jewell Pkwy Ne Ste 330, Gainesville, GA 30501-3801 | 2020-01-30 |
| 1386062255 | Northside Hospital, Inc. | Clinic/Center | 4553 N Shallowford Rd, Ste. 60-c, Atlanta, GA 30338-6408 | 2014-03-28 |
| 1225050396 | Northside Hospital, Inc. | General Acute Care Hospital | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2006-07-24 |
| 1376574277 | Northside Hospital, Inc. | General Acute Care Hospital | 1200 Northside Forsyth Dr, Cumming, GA 30041-7659 | 2006-07-06 |
| Street Address |
1240 JESSE JEWELL PKWY SE STE 550 |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932723772 | Akb LLC | Pharmacy | 842 E California St Ste A, Gainesville, TX 76240-4202 | 2020-06-06 |
| 1164042867 | Northeast Georgia Medical Center, Inc. | Pharmacy | 1439 Jesse Jewell Pkwy Ne, Gainesville, GA 30501-3806 | 2020-04-22 |
| 1376020883 | Avp Pharma LLC | Pharmacy | 7261 Nw 4th Blvd, Gainesville, FL 32607-1600 | 2018-07-26 |
| 1306365010 | Holiday Cvs, L.L.C. | Pharmacy | 250 Nw 13th St, Gainesville, FL 32601-5166 | 2017-09-13 |
| 1700300506 | Pharmasutra Pllc | Pharmacy | 7963 Heritage Village Plz, Gainesville, VA 20155-3077 | 2017-08-02 |
| 1336569946 | Anderson-scokelee, Inc | Pharmacy | 5001 Nw 34th Blvd Ste B, Gainesville, FL 32605-1190 | 2014-04-22 |
| 1871852848 | Gainesville Pharmacy LLC | Pharmacy | 7963 Heritage Village Plaza, Gainesville, VA 20155 | 2012-05-11 |
| 1700112000 | Shands Teaching Hospital and Clinics, Inc. | Pharmacy | 1515 Sw Archer Rd., Room 1010, Gainesville, FL 32608 | 2009-10-22 |
| 1003015371 | Harris Teeter, LLC | Pharmacy | 7910 Crescent Park Dr., Gainesville, VA 20155 | 2007-07-16 |
| 1518001296 | Court Square Pharmacy | Pharmacy | 101 East Third, Gainesville, MO 65655-0414 | 2007-02-16 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.