Cordele Dialysis Center LLC

Key facts

NPI

1770763567

Entity type

Organization (NPI type 2)

Primary specialty

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

Legal business name

CORDELE DIALYSIS CENTER LLC

Practice address

1013 E 16TH Ave
Cordele, GA 31015-1539

Phone

(229) 273-0163

NPI assigned

Nov 8, 2007

Organization subpart

No

Authorized official

Name

Jim Hilger

Title

Vice President

Phone

(253) 382-1919

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Burlington, WA · NPI 1932595584
  NPD member Member Of

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

Other names

• Cordele Dialysis Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 6, 2009.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1770763567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "STE 400 L&C",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4521",
            "fax_number": "866-594-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 E 16TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310151539",
            "telephone_number": "229-273-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDELE DIALYSIS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "253-382-1919"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "882488002A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordele Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordele, GA

• Rebecca Webb Coen, PHARMD
• April Coleene Coffee, M. ED. CCC-SLP
• Derrick Deandre Collier
• Elizabeth Anne Cook, OTR/L
• Waretta Sawyer Cooks, NP
• Cordele Family Medicine PC
• Cordele Health and Rehabilitation Center, Inc.
• Cordele Internal Medicine
• Cordele Optical Disp., Inc.
• Cordele Personal Care Home

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