Organization Name: | RENAL TREATMENT CENTERS MID ATLANTIC INC |
NPI Number: | 1689643306 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
Mailing Address: | 102 East Burkhalter Ave Suite A Buena Vista |
State: | GA US |
Postal Code: | 318031701 |
Phone Number: | 2296495017 |
Fax Number: | 2296496410 |
NPI Enumeration Date: | 03/15/2006 |
NPI Last Update Date: | 10/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | ESRD001122 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |