Central Georgia Dialysis LLC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Macon, GA. Organization (NPI-2).
NPI number1073582425
StatusActive
Last updated in NPPESJul 1, 2025
Details
- NPI
- 1073582425
- Entity type
- Organization (NPI-2)
- Legal business name
- Central Georgia Dialysis LLC
- Organization subpart
- No
- Enumeration date
- Mar 17, 2006
- Certification date
- Jul 1, 2025
- Last updated
- Jul 1, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | ESRD001047 | GA | Yes |
Other names
- East Macon Dialysis Center (Doing Business As)
Practice location
165 Emery Hwy Ste 101Macon, GA 31217-3617
Phone 478-755-1144 · Fax 478-755-1127
Mailing address
5200 Virginia WayBrentwood, TN 37027-7569
Authorized official
Samuel T Wey
Vp Licensure & Certification
6153416641
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