Organization
WEST GEORGIA MEDICAL CENTER, INC.
Active
Other names
West Georgia Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J BUDZINSKI (EVP)
(470) 644-0012
Entity
Organization
Contact information
Practice address
140 GLENN BASS RD, LAGRANGE, GA 30240-5809
(706) 845-3282
(706) 845-3474
Mailing address
1800 PARKWAY PL SE STE 500, MARIETTA, GA 30067-8237
(470) 956-4981
(770) 999-2489
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
—
00409186A
—
GA
Enumeration date
09/03/2009
Last updated
02/24/2020
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