Organization
UNION COUNTY DIALYSIS, LLC
Active
Other names
UNION COUNTY DIALYSIS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS COLBY TOWNSEND (CHIEF FINANCIAL OFFICER)
(706) 745-2111
Entity
Organization
Contact information
Practice address
72 APPALACHIAN AVE, BLAIRSVILLE, GA 30512-2271
(706) 745-2111
Mailing address
35 HOSPITAL RD, BLAIRSVILLE, GA 30512-3139
(706) 745-2111
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
ESRD001173
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000876048B
—
GA
05
—
0112680
—
TN
05
—
1102680
—
NC
01
—
112680
MEDICARE ID
GA
Enumeration date
10/07/2016
Last updated
01/10/2017
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