NPI age
20 years
Enumerated 2005-12-07
● Active Type 2 · Organization
Northside Hospital, Inc.
Northside Hospital, Inc. is 1 of 321 pharmacy organizations in Georgia.
Primary specialty
Pharmacy
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Gardner
Director, Pharmaceutical Services
Last NPPES update
2020-11-10
Source: monthly bulk 2026-05
How this organization compares
Across 321 active pharmacy providers in Georgia.
NPI age
20 years
↑ 15 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 30% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-12Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
650 Professional Dr
Lawrenceville, GA 300468707
Mailing address
1000 Johnson Ferry Road, Attn: Judy Gardner
Atlanta, GA 303421616
Authorized official
Judy Gardner, PHARMD, FASHP
Director, Pharmaceutical Services
📞 4048516793
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Pauline Bondoc-Roaquin, P.T. Physical Therapist NPI 1487998761
- Susan Sysol Community Health Worker NPI 1598031973
Specialties
-
Pharmacy PrimaryA pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other...
-
General Acute Care HospitalAn acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1147215 | NABP OR NCPDP |
| 05 (GA) | 866291A |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Northside Gwinnett Extended Care Center Pharmacy
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.