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Organization

CENTRAL GEORGIA DIALYSIS LLC

Active
Other names
East Macon Dialysis Center
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
165 EMERY HWY STE 101, MACON, GA 31217-3617
(478) 755-1144
(478) 755-1127
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001047
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110252752A
GA
Enumeration date
03/17/2006
Last updated
07/01/2025
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