Organization
DCA OF CENTRAL VALDOSTA LLC
Active
Parent organization
U S RENAL CARE INC
Other names
U S Renal Care Central Valdosta Dialysis
Organization subpart
Yes
Provider details
NPI number
Legal business name
U S RENAL CARE INC
Authorized official
MR. THOMAS L. WEINBERG (VICE PRESIDENT & SECRETARY)
(214) 736-2700
Entity
Organization
Contact information
Practice address
506 N PATTERSON ST, VALDOSTA, GA 31601-4608
(229) 219-0099
(229) 219-7331
Mailing address
PO BOX 19119, JONESBORO, AR 72403-6601
(870) 931-5400
(870) 931-5418
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
—
000895309E
—
GA
01
—
112699
VA MEDICAL CENTER
GA
Enumeration date
04/07/2006
Last updated
06/21/2018
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