Poplar Dialysis

LBN: Havenwood Dialysis Llc
Poplar Dialysis is an health care organization with primary practice located at 2301 Newnan Crossing Blvd Ste 180, Newnan GA 30265-2576. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Havenwood Dialysis Llc can be contacted via phone (770) 253-2403, or through Wey, Samuel T via phone (615) 341-6641.

Contact Information

Primary practice address
2301 Newnan Crossing Blvd Ste 180 Newnan GA 30265-2576
Phone: (770) 253-2403
Fax: (770) 253-8092
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel T
Phone: (615) 341-6641

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X Georgia

Profile Details

NPI number 1003311341
LBN Legal business name Havenwood Dialysis Llc
DBA Doing business as Poplar Dialysis
Authorized official Wey, Samuel T
Entity Organization
Organization subpart 1 No
Enumeration date Mar 28th, 2018
Last updated May 9th, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003311341 NPPES
Georgia MEDICAID 003221969A

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