Demorest Dialysis Facility, L.L.C.
Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Demorest, GA
NPI 1215925375 · NPPES record last updated Mar 15, 2011
Key facts
- NPI
- 1215925375
- Entity type
- Organization (NPI type 2)
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
- License
- ESRD001213 (GA)
- Legal business name
- DEMOREST DIALYSIS FACILITY, L.L.C.
- Practice address
- 1507 Central Ave
Demorest, GA 30535-4555 - Phone
- (706) 433-0683
- Fax
- (706) 369-1478
- NPI assigned
- Oct 12, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Kristy W Duncan
- Title
- Billing Specialist
- Phone
- (706) 433-0683
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | ESRD001213 | GA | Yes |
Addresses
Primary practice location
1507 Central Ave
Demorest, GA 30535-4555
Mailing address
PO Box 6385
Athens, GA 30604-6385
Phone (706) 546-0083
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 885141164A | Medicaid | GA |
Other providers in Demorest, GA
- Haley Patton Dadd
- Mario N Dalesandro
- Linh My Dao
- Bailey M Daughtery
- Dana Davis
- DFG LLC
- Sheila Dickerson
- Rebecca Abigail Dondanville
- Esther Dorzin
- Gisselle Duarte
All providers in Demorest, GA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.