Organization
DELRAY BEACH DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON BOUCHER (CFO)
(978) 922-3080
Entity
Organization
Contact information
Practice address
5130 LINTON BLVD, SUITE G4, DELRAY BEACH, FL 33484-6596
(561) 498-5959
(561) 498-5949
Mailing address
5130 LINTON BLVD, SUITE G-4, DELRAY BEACH, FL 33484-6596
(561) 498-5959
(561) 498-5949
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
—
892299300
—
FL
Enumeration date
07/04/2006
Last updated
03/21/2019
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