Organization
FORT VALLEY DIALYSIS CENTER 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
135 AVERA DR, FORT VALLEY, GA 31030-5007
(478) 827-0776
(478) 827-0699
Mailing address
135 AVERA DR, FORT VALLEY, GA 31030-5007
(478) 827-0776
(478) 827-0699
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2017
Last updated
01/13/2023
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