Organization
GEORGIA KIDNEY INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MORUFU ALAUSA MD (CHIEF MEDICAL DIRECTOR)
(815) 714-7171
Entity
Organization
Contact information
Practice address
1625 HARDEMAN AVE, MACON, GA 31201-1417
(478) 257-5200
Mailing address
PO BOX 3134, JOLIET, IL 60434-3134
(815) 714-7171
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
055819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003124971A
—
GA
01
—
1962825844
NPI
GA
Enumeration date
01/28/2014
Last updated
05/25/2022
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