Organization
PHYSICIANS CHOICE DIALYSIS OF BRISTOW LLC
Active
Organization
PHYSICIANS CHOICE DIALYSIS OF BRISTOW LLC
Active
Other names
PCD Bristow
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY SMITH (DIRECTOR OF LEGAL)
(610) 495-8900
Entity
Organization
Contact information
Practice address
402 S MAIN ST, BRISTOW, OK 74010-3204
(610) 495-8900
(610) 495-8560
Mailing address
211 COMMERCE CT, SUITE 104, POTTSTOWN, PA 19464-3483
(610) 495-8900
(610) 495-8560
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
—
200486820A
—
AL
Enumeration date
10/15/2011
Last updated
02/06/2015
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