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NPI Code Detail

MEDICARE: HIGHLAND OAKS DIALYSIS CENTER OF WAKE FOREST UNIVERSITY

MEDICARE: HIGHLAND OAKS DIALYSIS CENTER OF WAKE FOREST UNIVERSITY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083287379
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND OAKS DIALYSIS CENTER OF WAKE FOREST UNIVERSITY
Provider Business Mailing Address
First Line : PO BOX 7350
Second Line :
City : TIFTON
State : GA
Zip : 31793-7350
Country : US
Telephone Number : 229-387-3528
Fax Number : 229-386-2149
Provider Business Practice Location Address
First Line : 730 HIGHLAND OAKS DR STE 101
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-7108
Country : US
Telephone Number : 336-793-0189
Fax Number : 336-793-0275
Authorized Official
Title or Position : CREDENTIALING COORD.
Name : MS. KIMBERLY AGEE-CLARK JOHNSON
Credential : MBA
Telephone Number : 229-387-3528
Provider Enumeration Date : 07/23/2021
Last Update Date : 02/09/2026

Similar Medicare Providers

1023017563 — DR. DENISE H. LAURIENTI M.D.
Practice Location Address:
730 HIGHLAND OAKS DR , SUITE 201
WINSTON-SALEM, NC
27103-7108
Practice Phone: 336-768-2425
Practice Fax: 336-768-4915
1407855968 — DR. WILLIAM SCOTT MOORE M.D.
Practice Location Address:
730 HIGHLAND OAKS DR , SUITE 201
WINSTON-SALEM, NC
27103-7108
Practice Phone: 336-768-2425
Practice Fax: 336-768-4915
1679572135 — DR. DOUGLAS W. STEWART M.D.
Practice Location Address:
730 HIGHLAND OAKS DR , SUITE 201
WINSTON-SALEM, NC
27103-7108
Practice Phone: 336-768-2425
Practice Fax: 336-768-4915
1316946858 — DR. GREGORY TODD GREENWOOD M.D.
Practice Location Address:
730 HIGHLAND OAKS DR , SUITE 201
WINSTON-SALEM, NC
27103-7108
Practice Phone: 336-768-2425
Practice Fax: 336-768-4915
1801895339 — DR. JAMES R. DILLEY M.D.
Practice Location Address:
730 HIGHLAND OAKS DR , SUITE 201
WINSTON-SALEM, NC
27103-7108
Practice Phone: 336-768-2425
Practice Fax:
1881679215 — ALEXANDER COX HADLEY MD
Practice Location Address:
730 HIGHLAND OAKS DR , SUITE 201
WINSTON SALEM, NC
27103-7108
Practice Phone: 336-768-2425
Practice Fax: 336-768-4915

Directions to “HIGHLAND OAKS DIALYSIS CENTER OF WAKE FOREST UNIVERSITY ” Practice Location

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