Organization · Type 2 NPI

Renal Treatment Centers Mid Atlantic Inc

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

NPI number 1508825704 Active

Practice location

2419 S Main St
Moultrie, GA 31768

Call (229) 890-1221 Map

Fax (229) 890-1226

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	ESRD001016 (GA)

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

Other end-stage renal disease (esrd) treatment clinic/center providers in Moultrie

See all in Moultrie →

NPI record

NPI: 1508825704
Entity type: Organization (Type 2)
Issued: Mar 17, 2006
Last updated: Apr 20, 2020
Status: Active

Other names

<unavail>
Moultrie Dialysis Center · doing business as
Moultrie Dialysis Center · doing business as

Authorized official

John D Winstel
Chief Accounting Officer
(253) 733-4501

Verify this record

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.

Is this your record? How to update it.

About NPI 1508825704

Renal Treatment Centers Mid Atlantic Inc's National Provider Identifier is 1508825704, issued on Mar 17, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Moultrie, GA. The record was last updated on Apr 20, 2020.