| Organization Name: | MEDSIDE PALLIATIVE CARE |
| NPI Number: | 1689790867 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YULIYA KORABELNIKOVA (CHA/ADMINISTRATOR) |
| Mailing Address: | 3384 Peachtree Rd Ne Atlanta |
| State: | GA US |
| Postal Code: | 303261181 |
| Phone Number: | 4046337433 |
| Fax Number: | 8886337430 |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 10/16/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |