NSH Cancer Institute Professional Services G, LLC

Organization Active NPI Hematology & Oncology Physician · Atlanta, GA

NPI 1124379284 · NPPES record last updated Oct 12, 2012

Key facts

NPI
1124379284
Entity type
Organization (NPI type 2)
Primary specialty
Hematology & Oncology Physician 207RH0003X
Legal business name
NSH CANCER INSTITUTE PROFESSIONAL SERVICES G, LLC
Practice address
1100 Johnson Ferry Rd NE
Suite 600
Atlanta, GA 30342-1709
Phone
(404) 851-6378
NPI assigned
Sep 28, 2012
Organization subpart
No

Authorized official

Name
Jorge Hernandez
Title
VP of Admin Services and Cco
Phone
(404) 851-6378

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 199

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 199

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130128000225 GA Part B Supplier - Clinic/Group Practice 0840443164 Receives reassigned benefits from 172 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Locations

3330 Preston Ridge Rd
Ste 1100
Alpharetta, GA 30005

320 Parkway Dr NE
Fl 2
Atlanta, GA 30312

308 Deep South Farm Rd
Ste 300
Blairsville, GA 30512

1505 Northside Blvd
Ste 3100
Cumming, GA 30041
Phone (770) 205-1331

134 Mountainside Village Pkwy
Bldg 500
Jasper, GA 30143
Phone (706) 253-7340

134 Mountainside Village Pkwy
#100
Jasper, GA 30143

6300 Hospital Pkwy
Ste 300
Johns Creek, GA 30097
Phone (770) 623-8965

5700 Hillandale Dr
Ste 250
Lithonia, GA 30058
Phone (770) 981-5431

111 Fieldstone Dr
Ste 116
Milledgeville, GA 31061
Phone (478) 453-1806

4298 W Atlanta Rd SE
Ste 200
Smyrna, GA 30080
Phone (404) 419-3080

1045 Southcrest Dr
Ste 210
Stockbridge, GA 30281

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RH0003X Yes
Pharmacy 333600000X

Addresses

Primary practice location

1100 Johnson Ferry Rd NE
Suite 600
Atlanta, GA 30342-1709

Mailing address

308 Coliseum Dr
Suite 150
Macon, GA 31217-3865

Other providers in Atlanta, GA

All providers in Atlanta, GA · Hematology & Oncology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.