| Organization Name: | MOSES DIALYSIS UNIT |
| NPI Number: | 1629155304 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RODNEY NELSON (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 220 Burdette St Saint Ignace |
| State: | MI US |
| Postal Code: | 497811712 |
| Phone Number: | 9066430408 |
| Fax Number: | 9066437821 |
| NPI Enumeration Date: | 11/01/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 495001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |