Organization
HAWTHORN KIDNEY CENTER WAREHAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN WILCOX (CFO)
(978) 922-3080
Entity
Organization
Contact information
Practice address
2991 CRANBERRY HWY, SUITE F1, EAST WAREHAM, MA 02538-1354
(508) 295-5290
(508) 295-5291
Mailing address
2991 CRANBERRY HWY, SUITE F1, EAST WAREHAM, MA 02538-1354
(508) 295-5290
(508) 295-5291
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110096821A
—
MA
Enumeration date
12/17/2012
Last updated
03/16/2017
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