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DIALYSIS CARE CENTER LAGRANGE LLC NPI 1548032360


NPI Information

NPI: 1548032360
Provider Name: DIALYSIS CARE CENTER LAGRANGE LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 11D2293284

Address:
109 PARKER DR
LAGRANGE, GA
ZIP 30240
Phone: (706) 350-4967
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DIALYSIS CARE CENTER LAGRANGE LLC is an end-stage renal disease (esrd) treatment clinic center in Lagrange, GA. DIALYSIS CARE CENTER LAGRANGE LLC NPI is 1548032360. The provider is registered as an organization entity type.

The provider's business location address is:

109 PARKER DR
LAGRANGE, GA
ZIP 30240-436
Phone: (706) 350-4967
Fax: (706) 350-4879

The provider's authorized official is Morufu Olatunji Alausa .
The authorized official title is Medical Officer and has the following contact phone number (815) 741-6830.

The CLIA number assigned to this NPI record is 11D2293284 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/25/2023 and was last updated on 10/25/2023.


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: 5/5/2024

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