| Southside Medical Center, Inc. | |
|
4945 Governors Dr Forest Park GA 30297-2134 | |
| (470) 426-8028 | |
| Not Available |
| Full Name | Southside Medical Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4945 Governors Dr, Forest Park, 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. 4945 Governors Dr Forest Park GA 30297-2134 Ph: (470) 426-8028 |
| NPI Number | 1730207663 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 01/19/2017 |
| Medicare PECOS PAC ID | 6901700723 |
|---|---|
| Medicare Enrollment ID | O20031229000661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730207663 | NPI | - | NPPES |
| 000444056E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Georgia) | Primary |
South Atlanta Joint & Rehab Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 541 Forest Pkwy Ste 14, Forest Park, GA 30297 Phone: 706-404-9011 | |
Emir Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4930 Governors Dr Ste 409, Forest Park, GA 30297 Phone: 404-366-3647 Fax: 404-366-3648 | |
Advance Ems Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4575 Jonesboro Rd, Forest Park, GA 30297 Phone: 404-993-3589 | |
Forest Park Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1019 Astor Ave, Forest Park, GA 30297 Phone: 404-366-9311 Fax: 404-366-1250 | |
Basden Family Practice, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4940 Governors Dr, Suite 203, Forest Park, GA 30297 Phone: 404-362-0282 Fax: 404-362-0285 | |
Bonserva Acute Primary Care Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4940 Governors Dr Ste 209, Forest Park, GA 30297 Phone: 404-366-8111 Fax: 404-366-8102 | |
Southern Crescent Family Practice, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 525 Forest Pkwy, Suite 100, Forest Park, GA 30297 Phone: 678-705-0100 Fax: 678-235-1800 |