| Organization Name: | KING DIALYSIS CENTER OF WAKE FOREST UNIVERSITY |
| NPI Number: | 1396722351 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY L HALES (ASSISTANT TREASURER) |
| Mailing Address: | 140 Moore Rd King |
| State: | NC US |
| Postal Code: | 270218770 |
| Phone Number: | 3369853531 |
| Fax Number: | 3369850718 |
| NPI Enumeration Date: | 12/29/2005 |
| 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: | NC |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |