PEDERNALES DIALYSIS LLC (NPI# 1013310150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013310150 |
| Entity Type | Organization |
| Organization Name | PEDERNALES DIALYSIS LLC |
| Other Organization Name | MILLER DIALYSIS |
| Practice Address |
213 Delores St Colquitt GA 39837-3528 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 2297581985 |
| Practice Fax Number | 2297582555 |
| Mailing Telephone | 6153204268 |
| Mailing Fax Number | 8772380567 |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2019-04-25 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003158694A | 05 |
| Other Name | Type Code |
|---|---|
| Miller Dialysis | Doing Business As Name - Organization |
| Street Address |
213 DELORES ST |
| City | COLQUITT |
| State | GA |
| Zip Code | 39837-3528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841818044 | Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-14 |
| 1679069231 | Vashawn Renee Mosley | Nurse Practitioner | Hospital Authority of Miller County, Miller County Hospital, 209 N. Cuthbert Street, Colquitt, GA 39837 | 2018-07-07 |
| 1427572361 | Brittany N. Harrison | Physical Therapist | 514 E. Crawford St., Colquitt, GA 39837 | 2017-08-02 |
| 1629417134 | Trevor Lee Butner | Family Medicine | Miller County Medical Center, 208 N. Cuthbert Street, Colquitt, GA 39837 | 2013-06-18 |
| 1942514609 | Mac Bradley Davis | Nurse Anesthetist, Certified Registered | 209 North Cuthbert Street, Colquitt, GA 39837 | 2010-08-04 |
| 1730410341 | Loving Care Personal Care Home | Assisted Living Facility | 168 East Crawford St, Colquitt, GA 39837 | 2010-01-21 |
| 1528110103 | The Hospital Authority of Miller County | Clinic/Center | 208 North Cuthbert St, Colquitt, GA 39837 | 2007-01-17 |
| 1780293035 | The Hospital Authority of Miller County | Pharmacy | 213 Delores Street, Colquitt, GA 39837 | 2020-07-23 |
| 1508372863 | Megan Odom Battles | Family Medicine | 208 N Cuthbert St, Colquitt, GA 39837 | 2017-12-22 |
| 1790108736 | Amy Askew Sanderson | Registered Nurse | 209 N Cuthbert St, Colquitt, GA 39837 | 2014-01-28 |
| Find all providers in zip 39837 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871190207 | Usrc Powder Springs Home LLC | Clinic/Center | 3721 New Macland Rd Ste 100b, Powder Springs, GA 30127-2000 | 2020-10-08 |
| 1083229280 | Bio- Medical Applications of Georgia, Inc. | Clinic/Center | 145 W Hendry St, Hinesville, GA 31313-3201 | 2020-09-14 |
| 1336759463 | Plattaz Dialysis, LLC | Clinic/Center | 100 Promenade Pkwy Ste C, Fayetteville, GA 30214-7735 | 2020-08-04 |
| 1174140743 | Home Dialysis Services Norcross LLC | Clinic/Center | 3780 Holcomb Bridge Rd Ste E, Norcross, GA 30092-4877 | 2020-06-30 |
| 1265058275 | Dialysis Care Center Pleasant Hill LLC | Clinic/Center | 1425 Georgia Ave Ste 102, Macon, GA 31201-6546 | 2020-06-25 |
| 1598389132 | Concerto Georgia LLC | Clinic/Center | 655 Exchange Cir Ste 100, Bethlehem, GA 30620-1767 | 2020-05-29 |
| 1629607098 | Rutledge Dialysis, LLC | Clinic/Center | 1719 New Hope Rd, Lawrenceville, GA 30045-6570 | 2020-04-07 |
| 1215562293 | Dialysis Clinic Inc | Clinic/Center | 1219 S. Martin Luther King Blvd., Americuse, GA 31719 | 2020-03-10 |
| 1659915882 | Filmore Dialysis, LLC | Clinic/Center | 4555 Atlanta Hwy Ste M, Loganville, GA 30052-2646 | 2019-10-31 |
| 1013562818 | Menca Dialysis, LLC | Clinic/Center | 3030 Headland Dr Sw Ste C, Atlanta, GA 30311-5435 | 2019-08-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.