TRINITY DIALYSIS CLINIC INC NPI 1245227560

NPI Information

NPI: 1245227560
Provider Name: TRINITY DIALYSIS CLINIC INC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 11D2136981

Address:
1354 CLEVELAND AVE
EAST POINT, GA
ZIP 30344
Phone: (404) 763-0405
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TRINITY DIALYSIS CLINIC INC is an end-stage renal disease (esrd) treatment clinic center in East Point, GA. TRINITY DIALYSIS CLINIC INC NPI is 1245227560. The provider is registered as an organization entity type.

The provider's business location address is:

1354 CLEVELAND AVE
EAST POINT, GA
ZIP 30344-431
Phone: (404) 763-0405
Fax: (404) 763-4223

The provider's authorized official is Michael Akintade .
The authorized official title is Ceo and has the following contact phone number (404) 763-0405.

The CLIA number assigned to this NPI record is 11D2136981 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2005 and was last updated on 1/26/2012.

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	000933831A	MEDICAID	GEORGIA
2	112702	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA	PROVIDER NUMBER

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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