Northside Gwinnett Extended Care Center Pharmacy

LBN: Northside Hospital, Inc.
Northside Gwinnett Extended Care Center Pharmacy is an health care organization with primary practice located at 650 Professional Dr , Lawrenceville GA 30046-8707. The organization recently has 2 registered licenses in different health care specialties including Hospitals / General Acute Care Hospital, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Northside Hospital, Inc. can be contacted via phone (678) 442-3642, or through Gardner, Judy via phone (404) 851-6793.

Contact Information

Primary practice address
650 Professional Dr Lawrenceville GA 30046-8707
Phone: (678) 442-3642
Fax: (770) 442-3066
Website:
Map and Directions
Authorized official contact:
Name: Gardner, Judy PHARMD, FASHP
Phone: (404) 851-6793

Health care specialties

SpecialtyCodeLicense #State
Hospitals / General Acute Care Hospital 282N00000X PHRE008388 Georgia
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1437134970
LBN Legal business name Northside Hospital, Inc.
DBA Doing business as Northside Gwinnett Extended Care Center Pharmacy
Authorized official Gardner, Judy PHARMD, FASHP
Entity Organization
Organization subpart 1 No
Enumeration date Dec 7th, 2005
Last updated Nov 10th, 2020 - about 6 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 1437134970 NPPES
Georgia Other 1147215 NABP OR NCPDP
Georgia MEDICAID 866291A NABP OR NCPDP

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