ARA-VIDALIA CLINIC LLC NPI 1871537654

NPI Information

NPI: 1871537654
Provider Name: ARA-VIDALIA CLINIC LLC

Doing Business As: NCA - VIDALIA

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
906 E 1ST ST
VIDALIA, GA
ZIP 30474
Phone: (912) 538-8908
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ARA-VIDALIA CLINIC LLC is an end-stage renal disease (esrd) treatment clinic center in Vidalia, GA. ARA-VIDALIA CLINIC LLC NPI is 1871537654. The provider is registered as an organization entity type.
The provider Is Doing Business As Nca - Vidalia.

The provider's business location address is:

906 E 1ST ST
VIDALIA, GA
ZIP 30474-207
Phone: (912) 538-8908
Fax: (912) 538-8909

The provider's authorized official is Christopher T Ford .
The authorized official title is President/ceo and has the following contact phone number (978) 922-3080.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 8/22/2020.

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			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	00972529C	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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