Organization
DIALYSIS CENTER OF MACON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
890 2ND ST, 1ST FLOOR, MACON, GA 31201-6863
(478) 743-0584
(478) 743-0585
Mailing address
890 2ND ST, 1ST FLOOR, MACON, GA 31201-6863
(478) 743-0584
(478) 743-0585
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
—
003160282A
—
GA
Enumeration date
01/29/2015
Last updated
01/10/2023
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