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Northside Hospital, Inc. fax number
(404) 845-1778
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Financial Assistance Department
Used for: Physician Practice Financial Assistance Application submission
Fax destination details
- Department
- Financial Assistance Department
- Purpose
- Physician Practice Financial Assistance Application submission
- Form
- Physician Practice Financial Assistance Application — Physician Practice Financial Assistance Application
- Address
- 1100 Johnson Ferry Road, Suite 780, Atlanta, GA 30342
- Voice phone
- 404-851-8021
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Submit the completed Physician Practice Financial Assistance Application with supporting documents (e.g., Tax Return IRS Form 1040, Social Security or disability benefit documentation, state income restrictions, proof of household size). Applications may be mailed to Northside Hospital Business Office at 1100 Johnson Ferry Road, Suite 780, Atlanta, GA 30342 (Attention: Financial Assistance) or faxed to 404-845-1778. For questions, contact the Northside Hospital Business Office at (404) 851-8021.
Official form instructions are published as a downloadable file on the organization's website.
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