RENAL TREATMENT CENTERS MID ATLANTIC INC NPI 1467421388

NPI Information

NPI: 1467421388
Provider Name: RENAL TREATMENT CENTERS MID ATLANTIC INC

Doing Business As: COLUMBUS DIALYSIS CENTER

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
6228 BRADLEY PARK DR
STE B
COLUMBUS, GA
ZIP 31904
Phone: (706) 596-8222
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RENAL TREATMENT CENTERS MID ATLANTIC INC is an end-stage renal disease (esrd) treatment clinic center in Columbus, GA. RENAL TREATMENT CENTERS MID ATLANTIC INC NPI is 1467421388. The provider is registered as an organization entity type.
The provider Is Doing Business As Columbus Dialysis Center.

The provider's business location address is:

6228 BRADLEY PARK DR
STE B
COLUMBUS, GA
ZIP 31904-604
Phone: (706) 596-8222
Fax: (706) 596-8381

The provider's authorized official is Samuel T Wey .
The authorized official title is Sr Director Licensure&certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 11D0675481 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/14/2006 and was last updated on 10/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	ESRD001098	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000728142A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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