Organization · Type 2 NPI

Qualicenters Pueblo, LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Canon City, CO

NPI number 1720190523 Active

Practice location

2245 Fremont Dr
Canon City, CO 81212-2533

Fax (719) 276-0015

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...

NPI record

NPI: 1720190523
Entity type: Organization (Type 2)
Issued: Aug 31, 2006
Last updated: Oct 13, 2023
Status: Active
Subpart: Yes of Fresenius Medical Care Holdings, Inc.

Other names

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Fresenius Medical Care Canon City Dialysis · doing business as

Authorized official

Barry L. Blanton
Vice President
(781) 699-9000

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About NPI 1720190523

Qualicenters Pueblo, LLC's National Provider Identifier is 1720190523, issued on Aug 31, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Canon City, CO. The record was last updated on Oct 13, 2023.