Organization
RENAL TREATMENT CENTERS - MID-ATLANTIC, INC.
Active
Other names
Fort Valley Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T. WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
557 BLUEBIRD BLVD, FORT VALLEY, GA 31030-5083
(478) 825-7208
(478) 825-3114
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001092
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000478189A
—
GA
Enumeration date
03/14/2006
Last updated
05/19/2025
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