340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH110161AV Northside Hospital, Inc. (Active)
Print
Main Details
Name
Northside Hospital, Inc.
Subdivision Name
Northside Stockbridge Imaging
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110161AV
Medicare Provider Number
110161
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/29/2014
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Northside Hospital, Inc.
Scott Wade, VP Finance
(404) 303-3381
Primary Contact
Northside Hospital, Inc.
Judy Gardner, Director of Pharmacy
(404) 851-6793
Addresses
Street Address
239 Village Center Parkway
Suite 160
Stockbridge, GA 30281
Billing Address
Northside Hospital
1000 Johnson Ferry Road
Atlanta, GA 39342
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session