SOUTHSIDE MEDICAL CENTER INC NPI 1548750573

NPI Information

  • NPI: 1548750573
  • Provider Name: SOUTHSIDE MEDICAL CENTER, INC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • CLIA Number: 11D0927068
  • Address: 540 FAYETTEVILLE RD SE
    ATLANTA, GA
    ZIP 30316
  • Phone: (404) 688-1350

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NPI Details

SOUTHSIDE MEDICAL CENTER, INC is a federally qualified health center (fqhc) clinic center in Atlanta, GA. SOUTHSIDE MEDICAL CENTER, INC NPI is 1548750573. The provider is registered as an organization entity type.

The provider's business location address is:

540 FAYETTEVILLE RD SE
ATLANTA, GA
ZIP 30316-306
Phone: (404) 688-1350

The provider's authorized official is Claudio Azzariti .
The authorized official title is Cfo and has the following contact phone number (404) 688-1350.

The CLIA number assigned to this NPI record is 11D0927068 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/15/2018 and was last updated on 5/15/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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