Organization
NRA NICHOLASVILLE KENTUCKY LLC
Active
Organization
NRA NICHOLASVILLE KENTUCKY LLC
Active
Other names
Nicholasville Dialysis Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON M. SUNDOCK (VICE PRESIDENT)
(615) 507-3307
Entity
Organization
Contact information
Practice address
220 BELLAIRE DRIVE, NICHOLASVILLE, KY 40356
(859) 881-8118
(859) 881-8212
Mailing address
1550 W. MCEWEN DRIVE, SUITE 500, FRANKLIN, TN 37067-1731
(615) 661-1100
(615) 507-3300
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
300190
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D1071037
CLIA
KY
05
—
PENDING
—
KY
Enumeration date
05/09/2007
Last updated
02/10/2011
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