Organization Name: | DIALYSIS CLINIC INC |
NPI Number: | 1124362561 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES E ATTRILL (PRESIDENT) |
Mailing Address: | 3492 Washington Rd East Point |
State: | GA US |
Postal Code: | 303445662 |
Phone Number: | 4047687890 |
Fax Number: | 4047686789 |
NPI Enumeration Date: | 11/26/2012 |
NPI Last Update Date: | 11/26/2012 |
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: |