Organization
COLLOM & CARNEY CLINIC ASSOCIATION
Active
Organization
COLLOM & CARNEY CLINIC ASSOCIATION
Active
Other names
Southwest Arkansas Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAT ROBERTS (ADMINISTRATOR)
(903) 614-3601
Entity
Organization
Contact information
Practice address
225 N. DUDNEY RD, MAGNOLIA, AR 71753-3110
(903) 614-3600
(903) 792-0951
Mailing address
4800 TEXAS BLVD, TEXARKANA, TX 75503-3033
(903) 614-3600
(903) 792-0951
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
—
132402734
—
AR
Enumeration date
11/16/2005
Last updated
03/23/2010
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