Organization · Type 2 NPI
Medlock Bridge Dialysis LLC
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Jasper, GA
NPI number
1245869619
Active
Practice location
700 N Main St
Jasper, GA 30143-1404
Fax (678) 387-1292
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 | None listed |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
About NPI 1245869619
Medlock Bridge Dialysis LLC's National Provider Identifier is 1245869619, issued on Apr 7, 2020. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Jasper, GA. The record was last updated on Oct 20, 2026.