Organization
SANDERSVILLE DIALYSIS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
614 S HARRIS ST, SANDERSVILLE, GA 31082-2821
(478) 552-6818
(478) 552-0858
Mailing address
614 S HARRIS ST, SANDERSVILLE, GA 31082-2821
(478) 552-6818
(478) 552-0858
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
—
000407591A
—
GA
Enumeration date
12/09/2014
Last updated
01/13/2023
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