Heavener Dialysis LLC
Victory Dialysis · Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)

Address: 2401 Shelby St, Columbus, GA 31903-0000
Phone: 7066825327

Heavener Dialysis LLC (NPI# 1689008740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1689008740
Entity Type Organization
Other Organization Name VICTORY DIALYSIS
Practice Address 2401 Shelby St
GA 31903-0000
Practice Telephone 7066825327
Practice Fax Number 7066826059
Mailing Address 5200 Virginia Way
L&c Dept
TN 37027-7569
Mailing Telephone 6153204286
Mailing Fax Number 8665942893
Authorized Official Name Mr. James K Hilger (CHIEF ACCOUNTING OFFICER)
Authorized Official Telephone 2537334500
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2013-08-26
Last Update Date 2013-08-26

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 261QE0700X Clinic/Center · End-Stage Renal Disease (ESRD) Treatment Ambulatory Health Care Facilities GA

Other Provider/Organization Names

Other Name Type Code
Victory Dialysis Doing Business As Name - Organization

Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

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Office Location

Street Address 2401 SHELBY ST
State GA
Zip Code 31903-0000

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437568771 Total Renal Care Inc Clinic/Center 2401 Shelby St, Columbus, GA 31903-3360 2014-08-12

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780104059 Southern Living Academy PCh Inc. Lodging 4225 Alton Strret, Columbus, GA 31903 2017-06-27
1902348980 Stephen Bible Technician, Other 113 Mosley Dr, Columbus, OH 31903 2016-11-08
1720501448 Charlene Elise Baltimore Counselor 2100 Comer Ave, Columbus, GA 31903 2017-07-25
1770759052 Soyini A. Fletcher Dentist 1600 Fort Benning Road, Columbus, GA 31903 2008-05-06
1124255955 Brenda Gail Robinson Licensed Practical Nurse 2703 Dawson St, Columbus, GA 31903-1342 2009-06-19
1871931923 Hope of Columbus, Inc. Assisted Living Facility 47 30th Ave, Columbus, GA 31903-1734 2013-06-11
1013382670 Michael V Williams Jr. Counselor 3110 Clay St, Columbus, GA 31903-1926 2015-12-08
1114130374 Jeffery Winfred Raney Social Worker 740 Winston Rd, Columbus, GA 31903-1940 2007-05-07
1326519489 Sabrina Marie Hailey Contractor 3390 N Lumpkin Rd Apt 1108, Columbus, GA 31903-2120 2018-12-16
1912505736 Patrick Banks Case Management 3390 N Lumpkin Rd Apt 1108, Columbus, GA 31903-2120 2020-10-14
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Zip Code 31903

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Dataset Information

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.