Organization
NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA LLC
Active
Other names
Nebraska Kidney Care
Organization subpart
No
Provider details
NPI number
Authorized official
DERON FRANK (SENIOR VP)
(310) 536-2402
Entity
Organization
Contact information
Practice address
638 N WEBB RD, SUITE B, GRAND ISLAND, NE 68803-4057
(308) 382-0121
(308) 382-0572
Mailing address
2000 16TH ST, DENVER, CO 80202
(303) 876-7243
(866) 917-5396
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025674900
—
NE
Enumeration date
10/28/2008
Last updated
01/07/2013
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