Organization
HISTORIC DIALYSIS LLC
Active
Other names
Forrest City Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (VICE PRESIDENT)
(253) 382-1919
Entity
Organization
Contact information
Practice address
1501 N WASHINGTON ST, FORREST CITY, AR 72335-2152
(870) 494-4022
(870) 494-4769
Mailing address
5200 VIRGINIA WAY, L&C DEPT 4TH FLOOR, BRENTWOOD, TN 37027-7569
(615) 320-4521
(866) 594-2894
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
01/26/2009
Last updated
10/29/2009
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