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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