Organization
GLACIER DIALYSIS LLC
Active
Organization
GLACIER DIALYSIS LLC
Active
Other names
North Park Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
324 FM 1960 RD STE 104, HOUSTON, TX 77073-1887
(281) 443-2209
(281) 443-1983
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6764
(833) 781-6999
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
—
322417201
—
TX
Enumeration date
10/05/2012
Last updated
08/26/2021
Update your record
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