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Organization

POOLER DIALYSIS LLC

Active
Other names
Pooler Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
JIM K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization

Contact information

Practice address
54 TRADERS WAY, POOLER, GA 31322-4158
(912) 748-1018
(912) 748-4187
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4286
(866) 594-2893

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD000772
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000619561AH
GA
Enumeration date
05/22/2008
Last updated
10/15/2014
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