Renal Treatment Centers Mid Atlantic Inc

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

ESRD001122 Issued in GA

Legal business name

RENAL TREATMENT CENTERS MID ATLANTIC INC

Doing business as

Buena Vista Dialysis

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

Last updated

Oct 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Chief Accounting Officer

Phone

(253) 733-4500

Specialties & licenses 1

Addresses

Other names 1

• Buena Vista Dialysis Doing business as

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1689643306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4286",
            "fax_number": "866-594-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 EAST BURKHALTER AVE",
            "address_2": "SUITE A",
            "city": "BUENA VISTA",
            "state": "GA",
            "postal_code": "318031701",
            "telephone_number": "229-649-5017",
            "fax_number": "229-649-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS MID ATLANTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4500"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "GA",
            "license": "ESRD001122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buena Vista Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Becky M Powell, RPH
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• Julia Roberts, RN
• Robert L Sales
• Tammy Albritton Singleton, NURSE PRACTITIONER
• Deshannon Swanson

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Buena Vista, GA
• Providers in Buena Vista, GA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.