ISD RENAL INC NPI 1073816914

NPI Information

NPI: 1073816914
Provider Name: ISD RENAL INC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
:
Address: 1041 WILLOW RUN RD
GREENSBORO, GA
ZIP 30642
Phone: (762) 815-5694

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NPI Details

ISD RENAL INC is an end-stage renal disease (esrd) treatment clinic center in Greensboro, GA. ISD RENAL INC NPI is 1073816914. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1041 WILLOW RUN RD
GREENSBORO, GA
ZIP 30642-760
Phone: (762) 815-5694
Fax: (762) 815-5701

The provider's authorized official is Samuel Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The enumeration date for this NPI number is 12/15/2010 and was last updated on 7/17/2025.

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	ESRD001127	GEORGIA	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	Other Provider Identifier Issuer
1	000768435A	MEDICAID	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: 11/21/2025

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