| Organization Name: | PINE BLUFF DIALYSIS INC |
| NPI Number: | 1073590923 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS L WEINBERG (VICE PRESIDENT GENERAL COUNSEL) |
| Mailing Address: | 2302 W 28th Ave Suite C Pine Bluff |
| State: | AR US |
| Postal Code: | 716035081 |
| Phone Number: | 8705347400 |
| Fax Number: | 8705410845 |
| NPI Enumeration Date: | 12/30/2005 |
| NPI Last Update Date: | 10/28/2013 |
| 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: | |