# ADVANCE MOBILE DIALYSIS INC.

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

## Provider details

- **NPI number:** 1740713148
- **Authorized official:** MR. DON ARNETT COOK JR. RT (OWNER/PRESIDENT)
- **Authorized official phone:** (318) 423-0159

## Contact information

- **Practice address:** 2054 BERMUDA ST, SHREVEPORT, LA 71105-3802
- **Practice address phone:** (318) 349-1826
- **Mailing address:** 2054 BERMUDA ST, SHREVEPORT, LA 71105-3802
- **Mailing address phone:** (318) 349-1826

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 10812630\#5PK73 | LA | Yes |

## Other

- **Enumeration date:** 04/04/2017
- **Last updated:** 04/04/2017