Organization
CORDELE DIALYSIS CENTER LLC
Active
Other names
Cordele Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JIM HILGER (VICE PRESIDENT)
(253) 382-1919
Entity
Organization
Contact information
Practice address
1013 E 16TH AVE, CORDELE, GA 31015-1539
(229) 273-0163
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4521
(866) 594-2894
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
—
882488002A
—
GA
Enumeration date
11/08/2007
Last updated
05/06/2009
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