NPI:
1467027482
Provider Name:
SOUTHSIDE MEDICAL CENTER, INC.
Doing Business As: SOUTHSIDE MEDICAL CENTER SCHOOL BASED HEALTH CENTER AT KIPP VISION
Classification:
Clinic/Center - 261QF0400X
Entity Type:
Organization
Specialization: Federally Qualified Health Center (FQHC)
Address:
660 MCWILLIAMS RD SE
ATLANTA, GA
ZIP 30315
Phone:
(678) 974-8148
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SOUTHSIDE MEDICAL CENTER, INC. is a federally qualified health center (fqhc) clinic center in Atlanta, GA. SOUTHSIDE MEDICAL CENTER, INC. NPI is 1467027482. The provider is registered as an organization entity type.
The provider Is Doing Business As Southside Medical Center School Based Health Center At Kipp Vision.
The provider's business location address is:
660 MCWILLIAMS RD SE
ATLANTA, GA
ZIP 30315-544
Phone: (678) 974-8148
Fax: (404) 688-2962
The provider's authorized official is Claudio Azzariti .
The authorized official title is Cfo and has the following contact phone number (404) 564-7009.
The enumeration date for this NPI number is 5/21/2021 and was last updated on 10/13/2021.