Organization
IHS OF GEORGIA, LLC
Active
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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