STOCKBRIDGE DIALYSIS CLINIC LLC NPI 1811938277

NPI Information

NPI: 1811938277
Provider Name: STOCKBRIDGE DIALYSIS CLINIC, LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 11D1089949

Address:
7444 HANNOVER PKWY S
SUITE 270
STOCKBRIDGE, GA
ZIP 30281
Phone: (678) 565-6228
Get Directions

STOCKBRIDGE DIALYSIS CLINIC, LLC is an end-stage renal disease (esrd) treatment clinic center in Stockbridge, GA. STOCKBRIDGE DIALYSIS CLINIC, LLC NPI is 1811938277. The provider is registered as an organization entity type.

The provider's business location address is:

7444 HANNOVER PKWY S
SUITE 270
STOCKBRIDGE, GA
ZIP 30281-303
Phone: (678) 565-6228
Fax: (678) 565-6246

The provider's authorized official is Mohamad Moussa Kassem .
The authorized official title is President and has the following contact phone number (678) 565-6228.

The CLIA number assigned to this NPI record is 11D1089949 - ambulatory surgery center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/9/2006 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	ESRD001247	GEORGIA	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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »