NPIMap

Organization Active NPI

Physicians Choice Dialysis of West Georgia II, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bremen, GA
National Provider Identifier
1013941707
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
ESRD001246 Issued in GA
Legal business name
PHYSICIANS CHOICE DIALYSIS OF WEST GEORGIA II, LLC
Practice address
108 Redding Dr
Bremen, GA 30110-2283
Phone
(770) 537-0222
Fax
(770) 537-1011
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Rhonda B Palumbo
Title
Director of Contracts/HR
Phone
(610) 495-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X ESRD001246 GA Primary

Addresses

Primary practice location

108 Redding Dr
Bremen, GA 30110-2283

Mailing address

211 Commerce CT
Suite 104
Pottstown, PA 19464-3483
Phone (610) 495-8900

Other names 1

  • PCD Bremen Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013941707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 COMMERCE CT",
            "address_2": "SUITE 104",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643483",
            "telephone_number": "610-495-8900",
            "fax_number": "610-495-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 REDDING DR",
            "city": "BREMEN",
            "state": "GA",
            "postal_code": "301102283",
            "telephone_number": "770-537-0222",
            "fax_number": "770-537-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CHOICE DIALYSIS OF WEST GEORGIA II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PALUMBO",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTS/HR",
        "authorized_official_telephone_number": "610-495-8900"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "ESRD001246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCD Bremen",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bremen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.