Organization
INNOVATIVE HOME DIALYSIS OF GEORGIA, LLC
Active
Parent organization
U.S. RENAL CARE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
U.S. RENAL CARE, INC.
Authorized official
THOMAS L. WEINBERG (SENIOR VICE PRESIDENT)
(214) 736-2700
Entity
Organization
Contact information
Practice address
3753 MARIETTA HWY, SUITE 100, CANTON, GA 30114-8328
(770) 345-4103
Mailing address
PO BOX 251549, PLANO, TX 75025-1500
(214) 736-2700
(214) 736-2790
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
—
003154586A
—
GA
Enumeration date
01/27/2014
Last updated
01/25/2017
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