PURE LIFE RENAL OF PERIMETER LLC NPI 1073057295

NPI Information

NPI: 1073057295
Provider Name: PURE LIFE RENAL OF PERIMETER, LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 49D2129415

Address:
6160 PEACHTREE DUNWOODY RD
SUITE A-110
ATLANTA, GA
ZIP 30328
Phone: (954) 962-5733
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PURE LIFE RENAL OF PERIMETER, LLC is an end-stage renal disease (esrd) treatment clinic center in Atlanta, GA. PURE LIFE RENAL OF PERIMETER, LLC NPI is 1073057295. The provider is registered as an organization entity type.

The provider's business location address is:

6160 PEACHTREE DUNWOODY RD
SUITE A-110
ATLANTA, GA
ZIP 30328-578
Phone: (954) 962-5733

The provider's authorized official is Jeff Fernandez .
The authorized official title is Cfo and has the following contact phone number (954) 962-5734.

The CLIA number assigned to this NPI record is 49D2129415 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/7/2016 and was last updated on 8/12/2022.

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

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

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