Putnam Dialysis Center
LBN: Nra-Eatonton, Georgia, Llc
Putnam Dialysis Center is an health care organization with primary practice located at 130 Hospital Perimeter Rd , Eatonton GA 31024-8502. 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.
Nra-Eatonton, Georgia, Llc can be contacted via phone (706) 484-0123, or through Sundock, Jon M. via phone (615) 507-3307.
Contact Information
Primary practice address
130 Hospital Perimeter Rd
Eatonton GA 31024-8502
Phone: (706) 484-0123
Fax: (706) 484-0959
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment | 261QE0700X | ESRD001102 | Georgia |
Profile Details
| NPI number | 1225085004 |
|---|---|
| LBN Legal business name | Nra-Eatonton, Georgia, Llc |
| DBA Doing business as | Putnam Dialysis Center |
| Authorized official | Sundock, Jon M. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 27th, 2006 |
| Last updated | Feb 10th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225085004 | NPPES |
| Georgia | Other | 11D1049747 | CLIA CERTIFICATE OF WAIVE |
| Georgia | MEDICAID | 028198194A | CLIA CERTIFICATE OF WAIVE |
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