Organization
MENCA DIALYSIS, LLC
Active
Other names
Camp Creek Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3030 HEADLAND DR SW STE C, ATLANTA, GA 30311-5435
(404) 349-6790
(404) 349-8095
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
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
—
003235091A
—
GA
Enumeration date
08/08/2019
Last updated
01/15/2026
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