Organization
PHYSICIANS DIALYSIS ACQUISITIONS INC
Active
Other names
PDI Highland Park
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
64 VICTOR ST, HIGHLAND PARK, MI 48203-3128
(313) 852-7700
(313) 852-7704
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
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
—
1528020021
—
MI
01
—
23D0951666
CLIA WAIVER
MI
Enumeration date
04/03/2006
Last updated
09/28/2022
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