Organization
PHYSICIANS CHOICE DIALYSIS OF JACKSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RHONDA B PALUMBO (DIRECTOR OF CONTRACTS/HR)
(610) 495-8900
Entity
Organization
Contact information
Practice address
331 HENRY ROAD SW, JACKSONVILLE, AL 36265
(610) 495-8900
(610) 495-8560
Mailing address
211 COMMERCE CT, SUITE 104, POTTSTOWN, PA 19464-3483
(610) 495-8900
(610) 495-8560
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
—
DIA2625D
—
AL
Enumeration date
01/08/2008
Last updated
10/02/2009
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