Organization
DCA OF HAWKINSVILLE LLC
Active
Parent organization
U S RENAL CARE INC
Other names
U S Renal Care Hawkinsville Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
U S RENAL CARE INC
Authorized official
MR. THOMAS L WEINBERG (VICE PRESIDENT & SECRETARY)
(214) 736-2700
Entity
Organization
Contact information
Practice address
292 INDUSTRIAL BLVD, STE 100, HAWKINSVILLE, GA 31036-8002
(478) 892-8008
(478) 892-8040
Mailing address
PO BOX 844631, DALLAS, TX 75284-4631
(870) 931-5400
(870) 931-5418
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
—
000936713A
—
GA
01
—
112707
BLUE CROSS
GA
Enumeration date
04/07/2006
Last updated
06/21/2018
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