Organization Name: | DIALYSIS CLINIC INC. |
NPI Number: | 1588697973 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES E. ATTRILL (PRESIDENT) |
Mailing Address: | 308 Louisiana Ave Ste 2 Libby |
State: | MT US |
Postal Code: | 599232159 |
Phone Number: | 4062939913 |
Fax Number: | 4062939915 |
NPI Enumeration Date: | 07/08/2006 |
NPI Last Update Date: | 05/05/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 10429 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |