Organization
PURIFICARE DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT FREDERIC (PRESIDENT)
(760) 473-8300
Entity
Organization
Contact information
Practice address
801 AVENUE H E STE 110, ARLINGTON, TX 76011-7701
(817) 709-4923
Mailing address
15255 HEATHER STONE CT, SAN DIEGO, CA 92127-3703
(760) 473-8300
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
08/22/2020
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