Organization Name: | SEMINOLE DIALYSIS LLC |
NPI Number: | 1275870503 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
Mailing Address: | 76 Highland Pavilion Ct Suite 129 Hiram |
State: | GA US |
Postal Code: | 301413170 |
Phone Number: | 6783841180 |
Fax Number: | 6783840662 |
NPI Enumeration Date: | 01/07/2013 |
NPI Last Update Date: | 08/16/2013 |
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: |