| Southside Medical Center, Inc | |
|
1030 Old Peachtree Rd Nw Ste 402 Lawrenceville GA 30043-3308 | |
| (770) 495-6222 | |
| (770) 495-9959 |
| Full Name | Southside Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1030 Old Peachtree Rd Nw Ste 402, Lawrenceville, Georgia |
| Authorized Official Name and Position | Claudio Azzariti (CFO) |
| Authorized Official Contact | 4045647009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Medical Center, Inc 1046 Ridge Ave Sw Atlanta GA 30315-1640 Ph: (404) 688-1350 | Southside Medical Center, Inc 1030 Old Peachtree Rd Nw Ste 402 Lawrenceville GA 30043-3308 Ph: (770) 495-6222 |
| NPI Number | 1861129850 |
|---|---|
| Provider Enumeration Date | 08/01/2022 |
| Last Update Date | 11/30/2022 |
| Medicare PECOS PAC ID | 6901700723 |
|---|---|
| Medicare Enrollment ID | O20230303000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861129850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Clinica Familiar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 706 Grayson Hwy, Suite 216, Lawrenceville, GA 30045 Phone: 770-513-7711 Fax: 770-513-3352 | |
Raymond L. Stovall, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Professional Dr, Suite 150, Lawrenceville, GA 30045 Phone: 678-376-1800 Fax: 678-376-5500 | |
Physicians Pointe Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1925 Old Peachtree Rd Ne, Lawrenceville, GA 30043 Phone: 770-339-5999 Fax: 770-277-9159 | |
Carehere Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 S Perry St Ste 200, Lawrenceville, GA 30046 Phone: 877-423-1330 | |
Bennett H. Bruckner,m.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 575 Professional Dr, Suite 290, Lawrenceville, GA 30045 Phone: 770-962-9410 Fax: 770-962-8489 | |
Metabolic Health Of Lawrenceville Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 720 Old Snellville Hwy Ste 150, Lawrenceville, GA 30044 Phone: 678-431-1119 | |
Sugarloaf Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4835 Sugarloaf Pkwy, Suite 300, Lawrenceville, GA 30044 Phone: 407-375-5940 Fax: 407-375-5952 |