Organization
KIDNEY INSTITUTE OF TUSCALOOSA, LLC
Active
Organization
KIDNEY INSTITUTE OF TUSCALOOSA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUNE A CLARK (VICE PRESIDENT)
(727) 733-2040
Entity
Organization
Contact information
Practice address
1964 BAYSHORE BLVD, SUITE C, DUNEDIN, FL 34698-2576
(727) 733-2040
Mailing address
701 UNIVERSITY BLVD E, SUITE 809, TUSCALOOSA, AL 35401-2086
(205) 247-2900
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
—
DIA2618D
—
AL
Enumeration date
07/05/2006
Last updated
02/20/2008
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