institution
Wilder Dialysis Llc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Conyers, Georgia
NPI 1720314776

Wilder Dialysis Llc is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Brentwood, GA and is specialized in End-Stage Renal Disease (ESRD) Treatment. Wilder Dialysis Llc practices in Conyers, GA. The NPI Number for Wilder Dialysis Llc is 1720314776 and holds a License No. ESRD000745 (Georgia).

The current practice location address for Wilder Dialysis Llc is 1501 Milstead Rd Ne, Conyers, GA and can be reached out via phone at 770-761-8097 and via fax at 770-761-8141. You can also correspond with Wilder Dialysis Llc through the mailing address at 5200 VIRGINIA WAY, BRENTWOOD, TN - 37027-7569 (mailing address contact number: 615-320-4268).

Location: 1501 Milstead Rd Ne, Conyers, GA, 37027-7569
institution
Provider Profile Details
NPI Number
1720314776
Provider Name
Wilder Dialysis Llc
Credential
Provider Entity Type
Organization
Address
1501 Milstead Rd Ne, Conyers, GA, 37027-7569
Phone Number
770-761-8097
Fax Number
770-761-8141
Provider Enumeration Date
10/27/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003101099A 05 GA
institution
Provider Business Practice Location Address Details
Address
1501 Milstead Rd Ne
City
State
Zip
30012-3838
Phone Number
770-761-8097
Fax Number
770-761-8141
person
Provider Business Mailing Address Details
Address
5200 Virginia Way
City
State
Zip
37027-7569
Phone Number
615-320-4268
Fax Number
877-238-0567
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
License No.
ESRD000745 (Georgia)
Definition
Definition to come...
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