Southside Medical Center, Inc.

NPI #1427175090 in Riverdale, Georgia

Provider Information

NPI Number: 1427175090
Entity Type: Organization
Organization Name: Southside Medical Center, Inc.
Primary Specialty: Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date: Mar 26, 2007
Last Updated: May 22, 2019

Practice Location

Address: 116 UPPER RIVERDALE RD SW
City: Riverdale
State: Georgia
ZIP Code: 30274
Phone: (678) 834-7847

Authorized Official

Name: CLAUDIO AZZARITI
Title: CFO
Phone: (404) 564-7009

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC)	261QF0400X	Primary

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