Southern Lane Dialysis

LBN: Dva Renal Healthcare Inc
Southern Lane Dialysis is an health care organization with primary practice located at 1840 Southern Ln , Decatur GA 30033-4033. 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. Dva Renal Healthcare Inc can be contacted via phone (404) 325-8884, or through Winstel, John via phone (253) 733-4501.

Contact Information

Primary practice address
1840 Southern Ln Decatur GA 30033-4033
Fax: (404) 325-8879
Website:
Authorized official contact:
Name: Winstel, John

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X ESRD001004 Georgia

Profile Details

NPI number 1770551905
LBN Legal business name Dva Renal Healthcare Inc
DBA Doing business as Southern Lane Dialysis
Authorized official Winstel, John
Entity Organization
Organization subpart 1 No
Enumeration date Mar 14th, 2006
Last updated Apr 1st, 2020 - about 5 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 1770551905 NPPES
Georgia MEDICAID 000622476C

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