Organization
SOUTH FULTON DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOB AGBOGU (MEDICAL DIRECTOR)
(404) 669-9669
Entity
Organization
Contact information
Practice address
3268 GREENBRIAR PKWY SW, ATLANTA, GA 30331-2604
(404) 997-6700
(404) 997-6710
Mailing address
1151 CLEVELAND AVENUE, SUITE A/B, EAST POINT, GA 30344-3618
(404) 669-9669
(404) 669-6998
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001133
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000823853A
—
GA
05
—
000823853B
—
GA
Enumeration date
12/06/2006
Last updated
07/21/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us