Organization
MANCHESTER DIALYSIS, LLC
Active
Other names
Southeast Fort Worth Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
3845 E LOOP 820 S, FORT WORTH, TX 76119-4337
(817) 496-9035
(817) 446-0012
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 997-4210
(866) 935-5481
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
—
364247201
—
TX
Enumeration date
07/03/2014
Last updated
09/01/2022
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