340B Drug Pricing Program Database
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CH04040A Southside Medical Center, Inc. (Active)
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Main Details
Name
Southside Medical Center, Inc.
Subdivision Name
SOUTHSIDE MEDICAL CENTER - Gresham Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003794
340B ID
CH04040A
Grant Number
H80CS00576
Additional Details
Current Program Status
Active
Registration Date
2/24/2010
Participating Start Date
4/1/2010
Participating Approval Date
3/10/2010
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Southside Medical Center, Inc
Claudio Azzariti, CFO
(404) 564-7009
Primary Contact
SOUTHSIDE MEDICAL CENTER
DAVID M. WILLIAMS, CEO
(404) 564-7030
Addresses
Street Address
2578 Gresham Rd SE
Atlanta, GA 30316-4138
Billing Address
Southside Medical Center, Inc.
1046 Ridge Ave.
Atlanta, GA 30315
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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