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Organization

THOMASVILLE DIALYSIS CENTER OF WAKE FOREST UNIVERSITY

Active
Other names
Thomasville Dialysis Center
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KIMBERLY AGEE-CLARK JOHNSON MBA (CREDENTIALING COORD.)
(229) 387-3528
Entity
Organization

Contact information

Practice address
10 LAURA LN, THOMASVILLE, NC 27360-5760
(336) 472-4500
(336) 472-4501
Mailing address
PO BOX 7350, TIFTON, GA 31793-7350
(229) 387-3528
(229) 386-2149

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001F2
BCBS-NC
NC
05
3402639
NC
Enumeration date
12/30/2005
Last updated
02/09/2026
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