Organization
ISD RENAL INC
Active
Other names
South Anthony Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 272-1916
Entity
Organization
Contact information
Practice address
7017 S ANTHONY BLVD, FORT WAYNE, IN 46816-2016
(260) 447-2220
(260) 447-2044
Mailing address
5200 VIRGINIA WAY, LICENSURE & CERTIFICATION, BRENTWOOD, TN 37027-7569
(615) 341-6374
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/24/2006
Last updated
11/03/2011
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