NPIMap

Organization Active NPI

Northside Hospital, Inc.

Doing business as Diagnostic Clinic Oncology Pharmacy

  • Community/Retail Pharmacy
  • Gainesville, GA
National Provider Identifier
1326679150
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NORTHSIDE HOSPITAL, INC.
Doing business as
Diagnostic Clinic Oncology Pharmacy
Practice address
1485 Jesse Jewell Pkwy NE Ste 330
Gainesville, GA 30501-3801
Phone
(470) 228-7070
NPI assigned
Jan 30, 2020
Last updated
Jul 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy E Fouts
Title
Chief Compliance Officer
Phone
(404) 851-6968

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1485 Jesse Jewell Pkwy NE Ste 330
Gainesville, GA 30501-3801

Mailing address

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606

Other names 1

  • Diagnostic Clinic Oncology Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200430001179 GA DME Supplier - Pharmacy 9830007236 Practice locations: Gainesville, GA

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Northside Hospital Inc1485 Jesse Jewell Pkwy NE, Gainesville, GA 30501-3801(470) 228-7070 Epoetin|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Feb 16, 2006

National Provider Directory

National Provider Directory
Tax ID family
Northsidedunwoody Surg16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northside Hospital ForsythCumming, GA, CCN 110005 Hospital 5% Or Greater Direct Ownership Interest Jul 25, 1991
Northside Hospital CherokeeCanton, GA, CCN 110008 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 25, 1991
Northside Hospital GwinnettLawrenceville, GA, CCN 110087 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 28, 2019

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1326679150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 JESSE JEWELL PKWY NE STE 330",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013801",
            "telephone_number": "470-228-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "FOUTS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "404-851-6968"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Clinic Oncology Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Diagnostic Clinic Oncology Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.