Organization
DIALYSIS OF NORTH ATLANTA LLC
Active
Other names
Ellijay Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (SR DIRECTOR, LICENSURE & CERTIFICAT)
(615) 341-6641
Entity
Organization
Contact information
Practice address
449 INDUSTRIAL BLVD STE 240, ELLIJAY, GA 30540-6724
(706) 719-5354
(706) 719-5355
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001205
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000973134A
—
GA
Enumeration date
03/14/2006
Last updated
10/02/2023
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