Organization
MY KIDNEY CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANISH PANDYA MD (OWNER)
(505) 278-8575
Entity
Organization
Contact information
Practice address
436 VISTA AVE, PAGE, AZ 86040-1478
(928) 608-1122
Mailing address
301 S LAKE ST, FARMINGTON, NM 87401-5619
(505) 278-8575
(505) 787-2399
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
03/28/2022
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