NEPHRON CORPORATION NPI 1104930023

NPI Information

NPI: 1104930023
Provider Name: NEPHRON CORPORATION

Doing Business As: WALTON DIALYSIS CENTER

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
710 BREEDLOVE DR
MONROE, GA
ZIP 30655
Phone: (770) 962-1231
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NEPHRON CORPORATION is an end-stage renal disease (esrd) treatment clinic center in Monroe, GA. NEPHRON CORPORATION NPI is 1104930023. The provider is registered as an organization entity type.
The provider Is Doing Business As Walton Dialysis Center.

The provider's business location address is:

710 BREEDLOVE DR
MONROE, GA
ZIP 30655-054
Phone: (770) 962-1231
Fax: (770) 513-2107

The provider's authorized official is Kirti K Shah .
The authorized official title is Medical Director and has the following contact phone number (770) 962-1231.

The CLIA number assigned to this NPI record is 11D2169859 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 3/9/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	000576386B	MEDICAID	GEORGIA
2	C09695	MEDICARE UPIN	GEORGIA
3	000576386A	MEDICAID	GEORGIA
4	112804	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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