| Southside Medical Center, Inc | |
|
3576 Highway 138 Se Stockbridge GA 30281-7909 | |
| (404) 688-1350 | |
| Not Available |
| Full Name | Southside Medical Center, Inc |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3576 Highway 138 Se, Stockbridge, Georgia |
| Authorized Official Name and Position | Claudio Azzariti (CFO) |
| Authorized Official Contact | 4045647009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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 3576 Highway 138 Se Stockbridge GA 30281-7909 Ph: (404) 688-1350 |
| NPI Number | 1144041062 |
|---|---|
| Provider Enumeration Date | 10/23/2024 |
| Last Update Date | 10/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144041062 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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