# PERITONEAL DIALYSIS SUPPLY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275526113
- **Authorized official:** MRS. JUNE A. CLARK (BUSINESS MANAGER)
- **Authorized official phone:** (727) 738-5255

## Contact information

- **Practice address:** 1964 BAYSHORE BLVD, SUITE C, DUNEDIN, FL 34698-2576
- **Practice address phone:** (727) 738-5255
- **Practice address fax:** (727) 733-0431
- **Mailing address:** 1964 BAYSHORE BLVD SUITE C, DUNEDIN, FL 34698-2576
- **Mailing address phone:** (727) 738-5255
- **Mailing address fax:** (727) 733-0431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BD1200X | Dialysis Equipment & Supplies (DME) | — | FL | Yes |

## Other

- **Enumeration date:** 08/25/2005
- **Last updated:** 04/10/2008