NSH CANCER INSTITUTE PROFESSIONAL SERVICES G LLC (NPI# 1205187374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205187374 |
| Entity Type | Organization |
| Organization Name | NSH CANCER INSTITUTE PROFESSIONAL SERVICES G LLC |
| Other Organization Name | NSH CIPS G |
| Practice Address |
132 Old Norton Rd Suite 200 Fayetteville GA 30215-4872 |
| Mailing Address |
1835 Savoy Dr Suite 300 Atlanta GA 30341-1072 |
| Practice Telephone | 6788171117 |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-12-28 |
| Authorized Official Name | JORGE J HERNANDEZ (VP OF ADMIN SERVICES AND CCO) |
| Authorized Official Telephone | 4048516378 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHSIDE HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| NSH CIPS G | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003167172 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 159 Enterprise Path, Suite 503, Hiram, GA 30141-7600 | 2012-09-28 |
| 1992058903 | Nsh Cancer Institute Professional Services G LLC | Pharmacy | 308 Coliseum Dr, Suite 120, Macon, GA 31217-3865 | 2012-10-16 |
| 1568713634 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 1045 Southcrest Dr, Suite 200, Stockbridge, GA 30281-6113 | 2012-09-28 |
| 1194076265 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 1668 Mulkey Rd, Suite A, Austell, GA 30106-1143 | 2012-09-28 |
| 1760733836 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 1100 Johnson Ferry Rd Ne, Suite 600, Atlanta, GA 30342-1709 | 2012-09-28 |
| 1679824742 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 790 Church St Ne, Suite 335, Marietta, GA 30060-7282 | 2012-09-28 |
| 1477804540 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 6300 Hospital Pkwy, Suite 300, Johns Creek, GA 30097-1828 | 2012-09-28 |
| 1821349994 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 320 Parkway Dr Ne, Suite 208, Atlanta, GA 30312-1213 | 2012-09-28 |
| 1801147970 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 747 S. 8th Street, Suite C, Griffin, GA 30224-4880 | 2012-09-28 |
| 1710238886 | Nsh Cancer Institute Professional Services G LLC | Durable Medical Equipment & Medical Supplies | 624 W Martin Luther King Jr Dr, Milledgeville, GA 31061-2787 | 2012-09-28 |
| Street Address |
132 OLD NORTON RD SUITE 200 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30215-4872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497733992 | Daniel Joseph Carr | Internal Medicine | 132 Old Norton Rd, Suite 200, Fayetteville, GA 30215-4872 | 2006-01-04 |
| 1235511338 | Jessica Nicole Mathis | Nurse Practitioner | 132 Old Norton Rd, Suite 200, Fayetteville, GA 30215-4872 | 2015-06-24 |
| 1558493619 | Letitia W Price | Physician Assistant | 132 Old Norton Rd, Suite 200, Fayetteville, GA 30215-4872 | 2007-03-12 |
| 1710992441 | Georgia Cancer Specialists I PC | Internal Medicine | 132 Old Norton Rd, Suite 200, Fayetteville, GA 30215-4872 | 2006-07-30 |
| 1912955840 | Gerald Alan Goldklang | Internal Medicine | 132 Old Norton Rd, Suite 200, Fayetteville, GA 30215-4872 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801370051 | Truly Nourished, LLC | Dietitian, Registered | 500 West Lanier Ave., Suite 908, Fayetteville, GA 30215 | 2018-09-23 |
| 1104343839 | Pandora G Brown | Specialist | 65 Black Watch Ct, Fayetteville, GA 30215 | 2017-08-23 |
| 1902264492 | Ty-re Lamont Dixon Sr. | Durable Medical Equipment & Medical Supplies | 220 Shoreline Dr., Fayetteville, GA 30215 | 2016-01-29 |
| 1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
| 1831534346 | Kevin Tyler Goelz | Radiology | 605 Wentworth Ct, Fayetteville, GA 30215 | 2013-05-10 |
| 1518249739 | William J. Holcomb | Pharmacist | 880 Hwy 85 South, Fayetteville, GA 30215 | 2011-09-14 |
| 1407168131 | All Care Home Health Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1000 Cooper Circle, Suite 201, Fayetteville, GA 30215 | 2010-07-10 |
| 1083854160 | Rachel Blanks | Licensed Practical Nurse | 170 Brookwood Lane, Fayetteville, GA 30215 | 2009-03-02 |
| 1093964975 | Brenda Carole Hayek | Nurse Practitioner | 735 Glynn Street S, Fayetteville, GA 30215 | 2008-09-16 |
| 1174700769 | Katheryn D. Mcdonell | Counselor | 110 Dawn Drive, Fayetteville, GA 30215 | 2008-01-25 |
| Find all providers in zip 30215 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265044150 | Getwell Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 310 Glynn St N Ste B401, Fayetteville, GA 30214-1105 | 2020-08-20 |
| 1548886450 | Care Medical Atlanta LLC | Durable Medical Equipment & Medical Supplies | 122 Robinson Ct, Fayetteville, GA 30214-6935 | 2020-06-17 |
| 1073149373 | Delta Medical Group Inc | Durable Medical Equipment & Medical Supplies | 375 E Millsap Rd Ste 1, Fayetteville, AR 72703-6289 | 2020-03-18 |
| 1154961472 | Zion Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 1572 Highway 85 N Ste 315, Fayetteville, GA 30214-7727 | 2020-01-14 |
| 1497314249 | Dme By Preventive Health Care Usa LLC | Durable Medical Equipment & Medical Supplies | 1572 Highway 85 N Ste 211, Fayetteville, GA 30214-7726 | 2019-06-06 |
| 1235696543 | Medic Rental Inc | Durable Medical Equipment & Medical Supplies | 3533 N Shiloh Dr Ste 4, Fayetteville, AR 72703-5317 | 2019-02-22 |
| 1720558893 | Broadband Innovation Group | Durable Medical Equipment & Medical Supplies | 2915 Raeford Rd Ste 203, Fayetteville, NC 28303-5491 | 2018-11-30 |
| 1508340464 | American Access and Management Services, LLC | Durable Medical Equipment & Medical Supplies | 1107 Four Wood Dr, Fayetteville, NC 28312-7227 | 2018-09-17 |
| 1629568506 | Kimberly Mcgaughey | Durable Medical Equipment & Medical Supplies | 1430 N Bernice Dr, Fayetteville, AR 72703-6084 | 2018-05-16 |
| 1033614771 | Mercy Home Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | 3801 Sycamore Dairy Rd Ste E, Fayetteville, NC 28303-3420 | 2018-03-26 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30215 |
Please comment or provide details below to improve the information on NSH CANCER INSTITUTE PROFESSIONAL SERVICES G LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.