Dialysis Clinic Inc. in Fayetteville - End-stage Renal Disease (esrd) Treatment
Dialysis Clinic Inc. - NPI 1043243421
Dialysis Clinic Inc. is a End-stage Renal Disease (esrd) Treatment in Fayetteville, Georgia. Dialysis Clinic Inc. practices all healthcare services and medical treatments related to End-stage Renal Disease (esrd) Treatment. The NPI Number for Dialysis Clinic Inc. is 1043243421. The last update date is 2023-10-04.
Dialysis Clinic Inc.'s current location address is 155 Brandywine Blvd, Fayetteville, Georgia. You can contact this provider via phone number 7707166940 and fax number 7707166944. The mailing address for Dialysis Clinic Inc. is 155 Brandywine Blvd, Fayetteville, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Dialysis Clinic Inc. |
|---|---|
| Address | 155 Brandywine Blvd, Fayetteville, Georgia |
| Phone Number | 7707166940 |
| Fax Number | 7707166944 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Schultz Donovan |
| Telephone Number | 6153273061 |
NPI Number Detail
| NPI Number | 1043243421 |
|---|---|
| Provider Enumeration Date | 2006-07-08 |
| Last Updated Date | 2023-10-04 |
Provider Mailing Address Detail
| Address | 155 Brandywine Blvd |
|---|---|
| City | Fayetteville |
| State | Georgia (GA) |
| Post Code | 302147628 |
| Phone Number | 7707166940 |
| Fax Number | 7707166944 |
Provider's Primary Taxonomy Detail
| Speciality | End-stage Renal Disease (esrd) Treatment |
|---|---|
| Taxonomy | 261Qe0700X |
| Licence No | ESRD001036 |
|
Definition: Provides dialysis and other medical care to patients with permanent kidney failure. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 000774287B | GA | -- | |
| 00774287A | GA | -- | |
| 00774287A | WI | -- |
Post Comment/ Review Below
What is the Dialysis Clinic Inc.'s unique identification number?
The Dialysis Clinic Inc. has been assigned the NPI (National Provider Identifier) Number 1043243421 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you kindly provide the complete physical address where Dialysis Clinic Inc.'s facilities are geographically located?
The facilities of Dialysis Clinic Inc. are physically situated at the following location: 155 Brandywine Blvd, Fayetteville, GA, 302147628.
What is the Dialysis Clinic Inc.'s specialty and taxonomy code?
The Dialysis Clinic Inc.'s specialty is End-stage Renal Disease (esrd) Treatment, and the corresponding taxonomy code is 261Qe0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1043243421 to Dialysis Clinic Inc.?
The Centers for Medicare & Medicaid Services originally issued the 1043243421 to Dialysis Clinic Inc. on 2006-07-08.
When was the information pertaining to Dialysis Clinic Inc. most recently updated or revised?
The details related to Dialysis Clinic Inc., including its address, specialty, and other relevant information, were last updated or revised on 2023-10-04.
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