Organization
PURE LIFE RENAL OF OVERLAND PARK, LLC
Active
Organization
PURE LIFE RENAL OF OVERLAND PARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF FERNANDEZ (CFO)
(954) 962-5733
Entity
Organization
Contact information
Practice address
11661 COLLEGE BLVD STE 106, OVERLAND PARK, KS 66210-4107
(954) 962-5733
Mailing address
4000 HOLLYWOOD BLVD STE 300N, HOLLYWOOD, FL 33021-1242
(954) 962-5733
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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