Provider Demographics
NPI:1114314598
Name:DSI MACON, LLC
Entity Type:Organization
Organization Name:DSI MACON, LLC
Other - Org Name:U.S. RENAL CARE MACON CLINTON DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:424 CHURCH ST
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2301
Mailing Address - Country:US
Mailing Address - Phone:615-777-8200
Mailing Address - Fax:
Practice Address - Street 1:280 CLINTON ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3954
Practice Address - Country:US
Practice Address - Phone:478-743-9506
Practice Address - Fax:478-742-3801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.R. RENAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-23
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA112516Medicare Oscar/Certification