Organization
ATHENS RENAL CENTER 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
2047 PRINCE AVE, SUITE A, ATHENS, GA 30606-6033
(706) 549-2133
(706) 549-2134
Mailing address
2047 PRINCE AVE, SUITE A, ATHENS, GA 30606-6033
(706) 549-2133
(706) 549-2134
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
—
003149145A
—
GA
Enumeration date
01/31/2014
Last updated
01/11/2023
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