ATHENS KIDNEY CENTER PC NPI 1659468056

NPI Information

NPI: 1659468056
Provider Name: ATHENS KIDNEY CENTER, PC

Doing Business As: COMMERCE KIDNEY CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
592 RIDGEWAY RD
SUITE A
COMMERCE, GA
ZIP 30529
Phone: (706) 335-6665
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ATHENS KIDNEY CENTER, PC is an end-stage renal disease (esrd) treatment clinic center in Commerce, GA. ATHENS KIDNEY CENTER, PC NPI is 1659468056. The provider is registered as an organization entity type.
The provider Is Doing Business As Commerce Kidney Center.

The provider's business location address is:

592 RIDGEWAY RD
SUITE A
COMMERCE, GA
ZIP 30529-334
Phone: (706) 335-6665
Fax: (706) 335-2475

The provider's authorized official is Azubueze Afam Adogu .
The authorized official title is President and has the following contact phone number (706) 543-6397.

The CLIA number assigned to this NPI record is 11D1099478 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/6/2006 and was last updated on 10/27/2009.

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	ESRD000758	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	112818	MEDICARE OSCAR/CERTIFICATION

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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