Organization
ISD RENAL INC
Active
Other names
Silver Creek Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
2011 E 32ND ST, STE 101, JOPLIN, MO 64804-3018
(417) 627-9490
(417) 627-9459
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6264
(800) 297-2925
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
—
1417494519
—
MO
Enumeration date
01/26/2017
Last updated
07/09/2020
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