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Organization

ISD RENAL INC

Active
Other names
Northwest Georgia Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization

Contact information

Practice address
260 HOSPITAL RD, CANTON, GA 30114-2409
(678) 880-3939
(770) 479-9466
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
(615) 320-4286
(866) 594-2893

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001260
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000410033B
GA
Enumeration date
01/17/2018
Last updated
01/17/2018
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