Organization
BULFINCH DIALYSIS LLC
Active
Organization
BULFINCH DIALYSIS LLC
Active
Other names
Lake Hartwell Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 280-9501
Entity
Organization
Contact information
Practice address
1065 E FRANKLIN ST, HARTWELL, GA 30643-2205
(706) 376-3285
(706) 376-1674
Mailing address
5200 VIRGINIA WAY, 4TH FLOOR - L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4286
(866) 594-2893
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD000713
GA
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127316A
—
GA
01
—
11D2041441
CLIA
GA
Enumeration date
05/03/2012
Last updated
04/10/2013
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