institution
Nra-valdosta, Georgia, Llc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Valdosta, Georgia
NPI 1194757237

Nra-valdosta, Georgia, Llc is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Valdosta, GA and is specialized in End-Stage Renal Disease (ESRD) Treatment. Nra-valdosta, Georgia, Llc practices in Valdosta, GA. The NPI Number for Nra-valdosta, Georgia, Llc is 1194757237 and holds a License No. ESRD00796 (Georgia).

The current practice location address for Nra-valdosta, Georgia, Llc is 1115 S Patterson St, Valdosta, GA and can be reached out via phone at 229-244-6045 and via fax at 229-244-6291.

Location: 1115 S Patterson St, Valdosta, GA, 31601-6347
institution
Provider Profile Details
NPI Number
1194757237
Provider Name
Nra-valdosta, Georgia, Llc
Credential
Provider Entity Type
Organization
Address
1115 S Patterson St, Valdosta, GA, 31601-6347
Phone Number
229-244-6045
Fax Number
229-244-6291
Provider Enumeration Date
07/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
770096220A 05 GA
11D1057790 01 GA CLIA CERT OF WAIVER
institution
Provider Business Practice Location Address Details
Address
1115 S Patterson St
City
State
Zip
31601-6347
Phone Number
229-244-6045
Fax Number
229-244-6291
person
Provider Business Mailing Address Details
Address
1115 S Patterson St
City
State
Zip
31601-6347
Phone Number
229-244-6045
Fax Number
229-244-6291
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
License No.
ESRD00796 (Georgia)
Definition
Definition to come...
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