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Organization

BRANSON DIALYSIS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JULIE A WILLIAMS (ADMINISTRATOR)
(417) 334-8288
Entity
Organization

Contact information

Practice address
101 SKAGGS RD STE 301, BRANSON, MO 65616-2062
(417) 334-8288
(417) 334-6966
Mailing address
101 SKAGGS RD STE 301, BRANSON, MO 65616-2062
(417) 334-8288
(417) 334-6966

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
154508734
AR
01
189725
BCBS
MO
05
502989320
MO
Enumeration date
01/31/2007
Last updated
11/08/2011
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