ELBERTON DIALYSIS FACILITY INC NPI 1417926411

NPI Information

NPI: 1417926411
Provider Name: ELBERTON DIALYSIS FACILITY INC

Doing Business As: ELBERTON DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
894 ELBERT ST
ELBERTON, GA
ZIP 30635
Phone: (706) 283-9833
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ELBERTON DIALYSIS FACILITY INC is an end-stage renal disease (esrd) treatment clinic center in Elberton, GA. ELBERTON DIALYSIS FACILITY INC NPI is 1417926411. The provider is registered as an organization entity type.
The provider Is Doing Business As Elberton Dialysis Center.

The provider's business location address is:

894 ELBERT ST
ELBERTON, GA
ZIP 30635-628
Phone: (706) 283-9833
Fax: (706) 283-9844

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 enumeration date for this NPI number is 3/14/2006 and was last updated on 12/20/2023.

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	ESRD001037	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	000407943A	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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