Organization
DIALYSIS AMERICA GEORGIA, LLC
Active
Other names
CENTRAL ATLANTA DIALYSIS
Organization subpart
No
Provider details
NPI number
Authorized official
MARK FAWCETT (TREASURER)
(781) 402-9000
Entity
Organization
Contact information
Practice address
22 EXECUTIVE PARK DRIVE, ATLANTA, GA 30329
(404) 417-1916
Mailing address
22 EXECUTIVE PARK DRIVE, ATLANTA, GA 30329
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
09/01/2006
Last updated
08/22/2020
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