Organization
PRIMROSE DIALYSIS, LLC
Active
Other names
May Street Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
712 S MAY ST, MADISONVILLE, TX 77864-2564
(936) 349-0326
(936) 349-0447
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6764
(833) 781-6999
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
—
110325
STATE LICENSE
TX
05
—
3781841
—
TX
Enumeration date
01/19/2015
Last updated
11/03/2020
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