Organization
NEVADA DIALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE A WILLIAMS (ADMINISTRATOR)
(417) 358-5500
Entity
Organization
Contact information
Practice address
324 N CENTENNIAL, NEVADA, MO 63772
(417) 358-5500
(417) 358-5510
Mailing address
2828 S GRAND AVE, CARTHAGE, MO 64836-7905
(417) 358-5500
(417) 358-5510
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
—
1578904728
—
MO
Enumeration date
07/16/2013
Last updated
11/19/2014
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