Organization
GROVETOWN DIALYSIS CLINIC LLC
Active
Other names
Nephrology Centers of America - Grovetown
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
444 PARK WEST DR, GROVETOWN, GA 30813-3216
(706) 863-3103
(706) 863-1778
Mailing address
444 PARK WEST DR, GROVETOWN, GA 30813-3216
(706) 863-3103
(706) 863-1778
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000950617F
—
GA
Enumeration date
05/04/2009
Last updated
01/10/2023
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