Organization
NEPHROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY LASHBROOK (CEO)
(574) 273-6787
Entity
Organization
Contact information
Practice address
710 PARK PLACE, MISHAWAKA, IN 46545-3519
(574) 273-6787
(574) 968-0882
Mailing address
250 EAST DAY ROAD, SUITE 300, MISHAWAKA, IN 46545-3519
(574) 273-6787
(574) 273-6757
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
—
200032320A
—
IN
Enumeration date
07/22/2005
Last updated
04/27/2010
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