Organization
BOARDMAN DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
7153 TIFFANY BLVD, BOARDMAN, OH 44514-1965
(330) 729-1355
(330) 729-1377
Mailing address
7153 TIFFANY BLVD, YOUNGSTOWN, OH 44514-1965
(330) 729-1355
(330) 729-1377
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
—
3093647
—
OH
Enumeration date
06/29/2009
Last updated
05/17/2023
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