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General NPI Number Information
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NPI Number | 1811403447
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Entity Type | Organization
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Legal Business Name | GILEAD DIALYSYS CENTER
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Dates
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Enumeration Date | 12/19/2017
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 1997 ANNAPOLIS EXCHANGE PKWY STE 300
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3273
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Country | US
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Telephone | 404-820-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 6436 CAMP CIR
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City | ADDIS
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State | LA
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Zip | 70710-3062
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Country | US
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Telephone | 404-820-9900
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GABBI JEMAR MCCLAY
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Credential |
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Telephone | 404-820-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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