Organization
KENTWOOD HOME DIALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES BERNARD HALL M.D. (OWNER)
(601) 320-3922
Entity
Organization
Contact information
Practice address
800 3RD ST, KENTWOOD, LA 70444-2746
(601) 833-4111
Mailing address
800 3RD ST, KENTWOOD, LA 70444-2746
(601) 833-4111
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
202586
LA
Other
Enumeration date
10/15/2014
Last updated
03/17/2015
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