Organization
IHS OF GEORGIA, LLC
Active
Other names
Advanced Kidney Therapies
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN MCDONNELL RN, BSN (PRESIDENT/COO)
(617) 328-7707
Entity
Organization
Contact information
Practice address
3200 COBB GALLERIA PKWY, SUITE 228, ATLANTA, GA 30339-5927
(617) 328-7707
(617) 328-7787
Mailing address
6001 BROKEN SOUND PKWY, SUITE 502, BOCA RATON, FL 33487-2765
(561) 443-0743
(561) 443-7296
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
—
003131469A
—
GA
Enumeration date
04/05/2012
Last updated
01/22/2015
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