| Southside Medical Center - Spalding County | |
|
409 W Solomon St Griffin GA 30223-2831 | |
| (678) 688-8700 | |
| Not Available |
| Full Name | Southside Medical Center - Spalding County |
|---|---|
| Speciality | Clinic/Center |
| Location | 409 W Solomon St, Griffin, Georgia |
| Authorized Official Name and Position | Claudio Azzariti (CFO) |
| Authorized Official Contact | 4046881350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Medical Center - Spalding County 1046 Ridge Ave Sw Atlanta GA 30315-1640 Ph: (404) 688-1350 | Southside Medical Center - Spalding County 409 W Solomon St Griffin GA 30223-2831 Ph: (678) 688-8700 |
| NPI Number | 1053789511 |
|---|---|
| Provider Enumeration Date | 09/14/2015 |
| Last Update Date | 09/14/2015 |
| Medicare PECOS PAC ID | 6901700723 |
|---|---|
| Medicare Enrollment ID | O20151113000268 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053789511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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