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Organization

BLANCOTT DIALYSIS, LLC

Active
Other names
Avonworth Dialysis
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization

Contact information

Practice address
259 MOUNT NEBO POINTE RD, PITTSBURGH, PA 15237-1313
(412) 364-3238
(412) 364-0523
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259

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
103704873
PA
Enumeration date
02/05/2019
Last updated
12/18/2020
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