Organization
NRA-VALDOSTA, GEORGIA, LLC
Active
Parent organization
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Other names
VALDOSTA DIALYSIS CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRESENIUS MEDICAL CARE HOLDINGS, INC.
Authorized official
BARRY L. BLANTON (VICE PRESIDENT)
(781) 699-9000
Entity
Organization
Contact information
Practice address
1115 S PATTERSON ST, VALDOSTA, GA 31601-6347
(229) 244-6045
(229) 244-6291
Mailing address
1115 S PATTERSON ST, VALDOSTA, GA 31601-6347
(229) 244-6045
(229) 244-6291
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD00796
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D1057790
CLIA CERT OF WAIVER
GA
05
—
770096220A
—
GA
Enumeration date
07/07/2006
Last updated
10/17/2023
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