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CH04040E SOUTHSIDE MEDICAL CENTER, INC. (Active)
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Main Details
Name
SOUTHSIDE MEDICAL CENTER, INC.
Subdivision Name
SOUTHSIDE MEDICAL CENTER - East Point Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-011209
340B ID
CH04040E
Grant Number
H80CS00576
Additional Details
Current Program Status
Active
Registration Date
4/12/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/13/2016
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
1100 Cleveland Ave
Atlanta, GA 30344-3602
Billing Address
Southside Medical Center, Inc.
1046 Ridge Ave. SW
Atlanta, GA 30315-1640
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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