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Organization

PIUTE DIALYSIS LLC

Active
Other names
North Atlanta Home Training
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization

Contact information

Practice address
1200 ALTMORE AVE STE 110, SANDY SPRINGS, GA 30342-2583
(404) 250-0925
(404) 250-9933
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD000750
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278517761A
GA
01
ESRD000750
ESRD FACILITY LICENSE
GA
Enumeration date
06/07/2017
Last updated
06/03/2025
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