Organization
RENAL TREATMENT CENTERS - MID-ATLANTIC, INC.
Active
Other names
Macland Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4110 AUSTELL POWDER SPRINGS RD STE 100, POWDER SPRINGS, GA 30127-2954
(770) 439-8775
(770) 439-8736
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMERNT, BRENTWOOD, TN 37027-7569
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
—
003208460A
—
GA
Enumeration date
08/18/2017
Last updated
06/13/2024
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