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Organization

COMMUNITY/PHYSICIANS DIALYSIS CENTER FAIRBORN, LIMITED

Active
Other names
CPDCF
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY S SPIERS RN,CNN (ADMINISTRATOR)
(937) 328-8933
Entity
Organization

Contact information

Practice address
1266 N BROAD ST, FAIRBORN, OH 45324-5549
(937) 879-0433
(937) 879-0589
Mailing address
247 S BURNETT RD, SUITE 110, SPRINGFIELD, OH 45505-2639
(937) 328-8921
(937) 525-2466

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
0674DC
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2337297
OH
Enumeration date
05/26/2006
Last updated
03/05/2010
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