Organization
THE LIGHTHOUSE DIALYSIS FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE K TERRY (CHAIRWOMAN)
(845) 659-7444
Entity
Organization
Contact information
Practice address
2901 N MAIN ST, TARBORO, NC 27886-1920
(252) 316-1033
(252) 822-0097
Mailing address
301 S CHURCH ST, SUITE #260, ROCKY MOUNT, NC 27804-5755
(252) 316-1033
(252) 822-0097
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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