Organization · Type 2 NPI

Renal Life Link Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Dallas, GA

NPI number 1073540506 Active

Practice location

4019 Johns Rd
Dallas, GA 30132-3420

Call (770) 445-3571 Map

Fax (770) 445-3898

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	ESRD001083 (GA)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1073540506
Entity type: Organization (Type 2)
Issued: Jun 28, 2006
Last updated: Jul 9, 2025
Status: Active

Other names

<unavail>
Paulding Dialysis · doing business as
Paulding Dialysis · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1073540506

Renal Life Link Inc's National Provider Identifier is 1073540506, issued on Jun 28, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Dallas, GA. The record was last updated on Jul 9, 2025.