NORTHSIDE HOSPITAL, INC.
NPI 1619558657
Pharmacy - Community/Retail Pharmacy in Lawrenceville, GA

Q: What is Northside Hospital, Inc.'s NPI number?

The NPI number for Northside Hospital, Inc. is 1619558657. It was assigned to this organization in the NPPES registry on April 20, 2021. The provider is doing business as Suburban Oncology Pharmacy.

Q: What is Northside Hospital, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since April 20, 2021

631 PROFESSIONAL DR STE 450, LAWRENCEVILLE, GA 30046(678) 533-1559 Get Directions Write a Review

NPPES record last updated: June 12, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 6, 2021, Apr 20, 2021 (2 updates tracked since 2021).

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About Northside Hospital, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHSIDE HOSPITAL, INC. (NPI 1619558657), doing business as Suburban Oncology Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Lawrenceville, Georgia and active in the NPI registry since April 2021. The organization lists Amy E Fouts, Chief Compliance Officer, as its authorized official.

NPPES Registry Identity

NPI1619558657

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameNORTHSIDE HOSPITAL, INC.

Location Address631 PROFESSIONAL DR STE 450Lawrenceville, GA 30046-3370

Mailing Address1000 Johnson Ferry RdAtlanta, GA 30342-1606 · (404) 851-6378

Phone(678) 533-1559

Organization SubpartNo

Authorized OfficialAmy E FoutsChief Compliance Officer · (404) 851-6968

Enumeration DateApril 20, 2021

Last NPPES UpdateJune 12, 20262 updates tracked since enumeration

NPPES CertifiedJune 12, 2026

✔ NPI 1619558657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

631 PROFESSIONAL DR STE 450, Lawrenceville, GA 30046

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Other Names 1

Doing Business AsSuburban Oncology Pharmacy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 3

Medicare supplier enrollment and the product categories Surburban Oncology Pharmacy carries, from the Medicare DMEPOS supplier directory.

Surburban Oncology Pharmacy

DMEPOS supplier · Lawrenceville, GAOperated by Northside Hospital Inc

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Accepts Medicare assignment

Surburban Oncology Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20574497

Medicare Participant SinceFebruary 16, 2006

Supplier Location631 Professional Dr Ste 450Lawrenceville, GA 30046

Phone(770) 963-8030

Supplier Specialties

Pharmacy

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRAVEEN SIVAKUMARAN MD

Internal Medicine (Hematology & Oncology)