Organization
MABLETON MEDICAL ENTERPRISES CORP
Active
Organization
MABLETON MEDICAL ENTERPRISES CORP
Active
Parent organization
MABLETON MEDICAL ENTERPRISES CORP
Other names
Mableton Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
MABLETON MEDICAL ENTERPRISES CORP
Authorized official
MS. OLUFUNMILAYO N/A ADEJOKUN (CEO)
(850) 728-2624
Entity
Organization
Contact information
Practice address
1380 VETERANS MEMORIAL HWY SW, MABLETON, GA 30126-3112
(770) 485-1773
(770) 627-3202
Mailing address
5080 JOHNS CREEK CT, ALPHARETTA, GA 30022-5186
(850) 728-2624
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
PENDING
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003104187A
—
GA
Enumeration date
01/04/2010
Last updated
12/22/2015
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