Organization
SOUTHERN RENAL GROUP, INC.
Active
Other names
Lindbergh Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENEDICT EHIRIM (PRESIDENT)
(404) 315-0605
Entity
Organization
Contact information
Practice address
2695 BUFORD HWY NE, SUITE 108, ATLANTA, GA 30324-3278
(404) 315-0605
(404) 315-0607
Mailing address
2695 BUFORD HWY NE, SUITE 108, ATLANTA, GA 30324-3278
(404) 315-0605
(404) 315-0607
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
001254
GA
Other
Enumeration date
05/11/2006
Last updated
08/22/2020
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