Organization
NOVA DIALYSIS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS KEMDI IHENACHO (MD/CEO)
(404) 296-7695
Entity
Organization
Contact information
Practice address
5329 MEMORIAL DR, STONE MOUNTAIN, GA 30083-3212
(404) 296-7695
Mailing address
PO BOX 870828, STONE MOUNTAIN, GA 30087-0021
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
038149
GA
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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