Organization
NORTH MAIN KIDNEY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
3900 NORTH MAIN ST, COLUMBIA, SC 29203-6445
(803) 779-1201
(803) 779-1202
Mailing address
3900 NORTH MAIN ST, COLUMBIA, SC 29203-6445
(803) 779-1201
(803) 779-1202
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
—
RE0023
—
SC
Enumeration date
04/27/2010
Last updated
01/10/2023
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