KIDNEY CARE GROUP INC.
Ambulatory Health at Highway 81, Loganville, GA

License number
Georgia ESRD001252
Category
Ambulatory Health
Type
End-Stage Renal Disease (ESRD) Treatment
Owner
Name: MS. SAIMA BASHIR
Title: OFFICE MANAGER
Phone: (706) 227-4075
Address
Address
3431 Highway 81, Loganville, GA 30052
National Provider ID: 1649357120
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KIDNEY CARE GROUP, INC

3431 Hwy 81 S, Loganville, GA 30052

Registration:
Oct 12, 2004
State ID:
0460926
Business type:
Domestic Profit Corporation
CFO:
L. Garry Poulsen (CFO), 8745 Cobblestone Pt Cir, Boynton Beach, FL 33437 (Physical)
Agent:
Garry Lee Poulsen,3977 Atlanta Hwy SUITE 104-105 LOGANVILLE GA, Loganville, GA 30052 (Physical)

Kidney Care Group, Inc

3977 Atlanta Hwy, Loganville, GA 30052

Industry:
Medical Doctor's Office
Office Manager, Principal:
Saima Bashir (Office Manager, Principal)

Ambulatory Health licenses in Georgia



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