Organization
HAWTHORN KIDNEY 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
537 FAUNCE CORNER RD, DARTMOUTH, MA 02747-1242
(508) 994-9692
(508) 991-8983
Mailing address
537 FAUNCE CORNER RD, DARTMOUTH, MA 02747-1242
(508) 994-9692
(508) 991-8983
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
—
110087758A
—
MA
Enumeration date
08/30/2010
Last updated
01/13/2023
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