Organization
SOUTHEASTERN RENAL DIALYSIS L.C.
Active
Parent organization
SOUTHEASTERN RENAL DIALYSIS L.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEASTERN RENAL DIALYSIS L.C.
Authorized official
MRS. MARY LIECHTY (ADMINISTRATOR)
(319) 385-6728
Entity
Organization
Contact information
Practice address
2000 A S MAIN ST, FAIRFIELD, IA 52556
(641) 469-3313
Mailing address
507 S WHITE ST, MT PLEASANT, IA 52641-2625
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
IA
Other
Enumeration date
03/05/2008
Last updated
07/21/2022
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