Northlake Dialysis

LBN: Renal Treatment Centers - Mid-Atlantic, Inc.
Northlake Dialysis is an health care organization with primary practice located at 1350 Montreal Rd Ste 200 , Tucker GA 30084-8144. 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. Renal Treatment Centers - Mid-Atlantic, Inc. can be contacted via phone (678) 406-0825, or through Wey, Samuel T via phone (615) 341-6641.

Contact Information

Primary practice address
1350 Montreal Rd Ste 200 Tucker GA 30084-8144
Phone: (678) 406-0825
Fax: (678) 406-0830
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 ESRD001189 Georgia

Profile Details

NPI number 1952379133
LBN Legal business name Renal Treatment Centers - Mid-Atlantic, Inc.
DBA Doing business as Northlake Dialysis
Authorized official Wey, Samuel T
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2006
Last updated Feb 1st, 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 1952379133 NPPES
Georgia MEDICAID 000479476M

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