Organization
PINE BLUFF DIALYSIS INC
Active
Parent organization
US RENAL CARE INC
Other names
Pine Bluff - US Renal Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
US RENAL CARE INC
Authorized official
MR. THOMAS L WEINBERG (CHAIRMAN)
(214) 736-2730
Entity
Organization
Contact information
Practice address
2800 W 28TH AVE, PINE BLUFF, AR 71603-4921
(870) 534-7400
Mailing address
PO BOX 251549, PLANO, TX 75025-1500
(870) 931-5400
(870) 931-5418
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
01
—
12564
BLUE CROSS BLUE SHIELD
AR
05
—
145245734
—
AR
Enumeration date
12/30/2005
Last updated
07/21/2022
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