340B Drug Pricing Program Database
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CH040400 Southside Medical Center, Inc. (Active)
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Main Details
Name
Southside Medical Center, Inc.
Subdivision Name
SOUTHSIDE MEDICAL CENTER - Main Center / Corporate HQ
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003601
340B ID
CH040400
Grant Number
H80CS00576
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
1/13/2010
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
1046 Ridge Ave SW
Atlanta, GA 30315-1640
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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1/13/10 UPDATED PHYS ADD (WAS 1039 RIDGE AVE, SW, ATLANTA)
01/13/2010
April 2025
April 2025
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