Organization
ISD RENAL INC
Active
Other names
Austell Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
3642 MARATHON CIR, AUSTELL, GA 30106-6821
(770) 439-4170
(770) 439-4252
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
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
—
042477788A
—
GA
Enumeration date
12/12/2008
Last updated
02/12/2019
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