Organization
CADDO DIALYSIS LLC
Active
Other names
General Butler 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
329 FLOYD DR STE B, CARROLLTON, KY 41008-8261
(502) 732-4713
(502) 732-8352
Mailing address
5200 VIRGINIA WAY, ATT: L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 238-3051
(800) 246-8346
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
—
7100212780
—
KY
Enumeration date
10/17/2011
Last updated
09/02/2022
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