Organization
NORTH RANDOLPH DIALYSIS CENTER OF WAKE FOREST UNIVERSITY
Active
Other names
North Randolph Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY AGEE-CLARK JOHNSON MBA (CREDENTIALING COORD.)
(229) 387-3528
Entity
Organization
Contact information
Practice address
5948 MENDENHALL ROAD EXT, ARCHDALE, NC 27263-4349
(336) 434-8910
(336) 434-8929
Mailing address
PO BOX 7350, TIFTON, GA 31793-7350
(229) 387-3528
(229) 386-2149
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
04/15/2016
Last updated
02/09/2026
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