PLATTAZ DIALYSIS LLC NPI 1336759463

NPI Information

  • NPI: 1336759463
  • Provider Name: PLATTAZ DIALYSIS, LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • :
  • CLIA Number: 11D2190542
  • Address: 100 PROMENADE PKWY STE C
    FAYETTEVILLE, GA
    ZIP 30214
  • Phone: (678) 788-6328

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NPI Details

PLATTAZ DIALYSIS, LLC is an end-stage renal disease (esrd) treatment clinic center in Fayetteville, GA. PLATTAZ DIALYSIS, LLC NPI is 1336759463. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

100 PROMENADE PKWY STE C
FAYETTEVILLE, GA
ZIP 30214-735
Phone: (678) 788-6328
Fax: (678) 788-6351

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 CLIA number assigned to this NPI record is 11D2190542 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/4/2020 and was last updated on 2/10/2025.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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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