Renal Treatment Centers Mid Atlantic Inc

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Buena Vista, GA

NPI 1689643306 · NPPES record last updated Oct 13, 2015

Key facts

NPI
1689643306
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
ESRD001122 (GA)
Legal business name
RENAL TREATMENT CENTERS MID ATLANTIC INC
Practice address
102 East Burkhalter Ave
Suite a
Buena Vista, GA 31803-1701
Phone
(229) 649-5017
Fax
(229) 649-6410
NPI assigned
Mar 15, 2006
Organization subpart
No

Authorized official

Name
James K Hilger
Title
Chief Accounting Officer
Phone
(253) 733-4500

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X ESRD001122 GA Yes

Addresses

Primary practice location

102 East Burkhalter Ave
Suite a
Buena Vista, GA 31803-1701

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Phone (615) 320-4286

Other identifiers

IdentifierTypeStateIssuer
000727394AMedicaidGA

Other names

  • Buena Vista Dialysis Doing business as

Other providers in Buena Vista, GA

All providers in Buena Vista, GA · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.