Organization
NAMG HOME DIALYSIS LLC
Active
Other names
Magnolia West At Home
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (SENIOR L&C ADMINISTRATOR)
(615) 341-6789
Entity
Organization
Contact information
Practice address
3660 PARK SIERRA DR, STE 103, RIVERSIDE, CA 92505-3081
(951) 373-4004
(951) 373-4005
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-5895
(866) 890-5560
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
—
1144427741
—
CA
Enumeration date
06/28/2007
Last updated
12/27/2013
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