Southside Medical Center, Inc. in Forest Park - Federally Qualified Health Center (fqhc)
Southside Medical Center, Inc. - NPI 1730207663
Southside Medical Center, Inc. is a Federally Qualified Health Center (fqhc) in Forest Park, Georgia. Southside Medical Center, Inc. practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for Southside Medical Center, Inc. is 1730207663. The last update date is 2017-01-19.
Southside Medical Center, Inc.'s current location address is 4945 Governors Dr, Forest Park, Georgia. You can contact this provider via phone number 4704268028. The mailing address for Southside Medical Center, Inc. is 4945 Governors Dr, Forest Park, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southside Medical Center, Inc. |
|---|---|
| Address | 4945 Governors Dr, Forest Park, Georgia |
| Phone Number | 4704268028 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CFO |
|---|---|
| Authorized Official Name | Azzariti Claudio |
| Telephone Number | 4045647009 |
NPI Number Detail
| NPI Number | 1730207663 |
|---|---|
| Provider Enumeration Date | 2007-03-27 |
| Last Updated Date | 2017-01-19 |
Provider Mailing Address Detail
| Address | 4945 Governors Dr |
|---|---|
| City | Forest Park |
| State | Georgia (GA) |
| Post Code | 302972134 |
| Phone Number | 4704268028 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
|
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000444056E | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Southside Medical Center, Inc. by the Centers for Medicare & Medicaid Services?
The Southside Medical Center, Inc. has been issued the NPI (National Provider Identifier) 1730207663, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Southside Medical Center, Inc.'s facilities are situated?
The facilities of Southside Medical Center, Inc. are physically located at the following address: 4945 Governors Dr, Forest Park, GA, 302972134.
What is the Southside Medical Center, Inc.'s specialty and taxonomy code?
The Southside Medical Center, Inc.'s specialty is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code is 261Qf0400X.
On what date did the Southside Medical Center, Inc. receive its 1730207663 assignment from the Centers for Medicare & Medicaid Services?
The Southside Medical Center, Inc. was assigned its 1730207663 by the Centers for Medicare & Medicaid Services on 2007-03-27.
As of what date was the information regarding Southside Medical Center, Inc., such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Southside Medical Center, Inc., including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2017-01-19.
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