Organization
FLAGLER DIALYSIS LLC
Active
Organization
FLAGLER DIALYSIS LLC
Active
Other names
Moreno Valley Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D. WINSTEL (CHEIF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
22620 GOLDENCREST DR, STE 101, MORENO VALLEY, CA 92553-9032
(951) 656-3804
(951) 656-7508
Mailing address
5200 VIRGINIA WAY, L&C DEPT., BRENTWOOD, TN 37027-7569
(615) 341-6793
(877) 790-2174
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
240000808
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346590106
—
CA
Enumeration date
09/19/2012
Last updated
02/17/2021
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