Bradley County Dialysis

NPI 1093133001 - Clinic/Center - 261QE0700X

NPI Details
NPI 1093133001
Enumeration Date 04/07/2014
Last Updated 04/07/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name KENT KENT
Position CEO
Phone (253) 382-1752
Fax
Practice Location
1423 PACIFIC AVE
TACOMA WA, 98402-4203, US
Phone (253) 382-1752
Fax
Business Location
204 BRAGG ST
WARREN AR, 71671-2500, US
Phone (870) 226-7180
Fax (870) 226-2488
Toxanomy
Taxonomy Code 261QE0700X
License State Arkansas
License Number 1194069617
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According to our database, Bradley County Dialysis NPI is 1093133001, taxonomy code is 261QE0700X and license number is 1194069617, license state is located at Arkansas. Bradley County Dialysis physically located at 1423 Pacific Ave, Tacoma WA, 98402-4203. NPI Number 1033115704 has the healthcare provider type.

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1093133001 NPI number is provided on an as is basis without warranty of any kind. 1093133001 is maintained by the National Plan & Provider Enumeration System. The contents of Bradley County Dialysis are for informational purposes only.