Organization
NEPHRON CORPORATION
Active
Other names
Northeast Georgia Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRTI K SHAH M.D. (MEDICAL DIRECTOR)
(770) 962-1231
Entity
Organization
Contact information
Practice address
440 SOUTH ENOTA ST, GAINESVILLE, GA 30501
(770) 962-1231
(770) 513-2107
Mailing address
605 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045
(770) 962-1231
(770) 513-2107
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000857491A
—
GA
05
—
000857491B
—
GA
Enumeration date
07/25/2006
Last updated
06/01/2009
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