Organization · Type 2 NPI
Historic Dialysis LLC
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Forrest City, AR
NPI number
1457599722
Active
Practice location
1501 N Washington St
Forrest City, AR 72335-2152
Fax (870) 494-4769
Mailing address
5200 Virginia Way, L&c Dept 4th Floor
Brentwood, TN 37027-7569
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary | 261QE0700X | None listed |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
Another provider at this address
Other end-stage renal disease (esrd) treatment clinic/center providers in Forrest City
About NPI 1457599722
Historic Dialysis LLC's National Provider Identifier is 1457599722, issued on Jan 26, 2009. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Forrest City, AR. The record was last updated on Oct 29, 2009.