Organization
NORTHERN SIERRA DIALYSIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT VAN WAGNER (DIRECTOR OF DIALYSIS)
(775) 982-4027
Entity
Organization
Contact information
Practice address
1500 E 2ND ST, SUITE 101, RENO, NV 89502-1181
(775) 982-8155
(775) 982-8104
Mailing address
1500 E SECOND ST, SUITE 101, RENO, NV 89502-1189
(775) 982-8155
(775) 982-8104
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
34710ESR-3
NV
Other
Enumeration date
09/27/2005
Last updated
12/28/2009
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