| Organization Name: | YADKIN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY |
| NPI Number: | 1013190982 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY L HALES (ASSISTANT TREASURER) |
| Mailing Address: | 225 Washington St Yadkinville |
| State: | NC US |
| Postal Code: | 270557751 |
| Phone Number: | 3366771182 |
| Fax Number: | 3366771183 |
| NPI Enumeration Date: | 12/13/2007 |
| NPI Last Update Date: | 03/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |