Organization
SOUTHWEST KIDNEY DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY WEINTRAUB (CHIEF EXECUTIVE OFFICER)
(480) 610-6100
Entity
Organization
Contact information
Practice address
5222 E BASELINE RD, SUITE 104, GILBERT, AZ 85234-2963
(480) 832-6996
(480) 832-7337
Mailing address
2149 E WARNER RD, SUITE 101, TEMPE, AZ 85284-3494
(480) 610-6100
(480) 610-6195
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
3623
AZ
Other
Enumeration date
05/08/2006
Last updated
08/22/2020
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