Organization Name: | VERITAS DIALYSIS INC. |
NPI Number: | 1063807634 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICHOLAS K IHENACHO (CEO) |
Mailing Address: | 5329 Memorial Dr Suite B Stone Mountain |
State: | GA US |
Postal Code: | 300833212 |
Phone Number: | 6782624181 |
Fax Number: | 6782624182 |
NPI Enumeration Date: | 04/01/2015 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |