Organization
MOUNTAIN WEST DIALYSIS SERVICES LLC
Active
Other names
Boulder Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
2880 FOLSOM ST, STE 110, BOULDER, CO 80304-3769
(303) 440-5600
(303) 440-4165
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4521
(866) 594-2894
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
—
86187589
—
CO
Enumeration date
06/24/2008
Last updated
12/19/2013
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