Organization
TIFT REGIONAL HEALTH SYSTEM, INC.
Active
Other names
Tift Regional Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DORMAN (PRESIDENT/CEO)
(229) 353-6104
Entity
Organization
Contact information
Practice address
1010 EDGEFIELD DR, TIFTON, GA 31794-2408
(229) 353-6208
(229) 353-7722
Mailing address
PO BOX 2650, TIFTON, GA 31793-2650
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
137-180
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000407338A
—
GA
Enumeration date
09/21/2006
Last updated
06/27/2022
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