Organization
EMORY DIALYSIS, LLC
Active
Other names
Emory Dialysis at Northside
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY AGEE-CLARK JOHNSON MBA (CREDENTIALING COORD.)
(229) 387-3528
Entity
Organization
Contact information
Practice address
610 NORTHSIDE DR NW, ATLANTA, GA 30318-6927
(404) 778-1050
(404) 892-1878
Mailing address
PO BOX 7710, TIFTON, GA 31793-7710
(229) 387-3528
(229) 386-2149
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
—
943588192A
—
GA
Enumeration date
05/22/2009
Last updated
02/09/2026
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