Organization
SOUTHWEST JACKSONVILLE DIALYSIS CENTER LLC
Active
Other names
Normandy Village Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
1584 NORMANDY VILLAGE PARKWAY, SUITE 29, JACKSONVILLE, FL 32221-6600
(904) 781-7272
(904) 781-4282
Mailing address
1584 NORMANDY VILLAGE PARKWAY, SUITE 29, JACKSONVILLE, FL 32221-6600
(904) 781-7272
(904) 781-4282
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
—
000739000
—
FL
Enumeration date
03/04/2008
Last updated
01/10/2023
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