Organization
TIFT REGIONAL HEALTH SYSTEM, INC.
Active
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
01
—
ESRD001119
STATE LICENSE
GA
Enumeration date
09/21/2006
Last updated
08/25/2026
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