Organization
COASTAL KIDNEY CENTERS LLC
Active
Other names
Coastal Kidney Centers LLC
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (GROUP VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
510 N MACARTHUR AVE, PANAMA CITY, FL 32401-3636
(850) 914-0824
(850) 914-2267
Mailing address
5200 VIRGINIA WAY, STE 400, BRENTWOOD, TN 37027-7569
(615) 320-4218
(303) 209-7825
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2006
Last updated
07/11/2007
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