Organization Name: | WHARTON DIALYSIS, INC. |
NPI Number: | 1215039490 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK FAWCETT (TREASURER) |
Mailing Address: | 1450 Highway 59 Loop N Wharton |
State: | TX US |
Postal Code: | 774887807 |
Phone Number: | 9795323757 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2006 |
NPI Last Update Date: | 08/29/2008 |
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: |