SHONE DIALYSIS LLC NPI 1508281817

NPI Information

NPI: 1508281817
Provider Name: SHONE DIALYSIS LLC

Doing Business As: NEWTON COUNTY DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
10132 CARLIN DR
COVINGTON, GA
ZIP 30014
Phone: (770) 385-8008
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SHONE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Covington, GA. SHONE DIALYSIS LLC NPI is 1508281817. The provider is registered as an organization entity type.
The provider Is Doing Business As Newton County Dialysis.

The provider's business location address is:

10132 CARLIN DR
COVINGTON, GA
ZIP 30014-651
Phone: (770) 385-8008
Fax: (770) 385-7287

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

The CLIA number assigned to this NPI record is 11D2161096 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/24/2014 and was last updated on 11/29/2023.

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		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	003148636A	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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