CLASSIC CITY DIALYSIS INC NPI 1871729855

NPI Information

NPI: 1871729855
Provider Name: CLASSIC CITY DIALYSIS INC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
2485 JEFFERSON ROAD
ATHENS, GA
ZIP 30606
Phone: (706) 543-3130
Get Directions

CLASSIC CITY DIALYSIS INC is an end-stage renal disease (esrd) treatment clinic center in Athens, GA. CLASSIC CITY DIALYSIS INC NPI is 1871729855. The provider is registered as an organization entity type.

The provider's business location address is:

2485 JEFFERSON ROAD
ATHENS, GA
ZIP 30606-100
Phone: (706) 543-3130
Fax: (706) 543-3215

The provider's authorized official is Emad Ahmed .
The authorized official title is President and has the following contact phone number (706) 543-3130.

The enumeration date for this NPI number is 6/4/2009 and was last updated on 3/7/2023.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	080069004	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	045157	OTHER	GEORGIA	STATE LICENSE
2	11443094883	OTHER		NPI
3	00783417	MEDICAID	GEORGIA
4	66151	OTHER		UPIN

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »