Organization
GREATER LAFAYETTE HEALTH SERVICES
Active
Other names
Dialysis Center of Lafayette
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRANCE E WILSON (CHIEF EXECUTIVE OFFICER)
(765) 423-6161
Entity
Organization
Contact information
Practice address
1000 NORTH 18TH STREET, LAFAYETTE, IN 47904
(765) 423-6351
Mailing address
1000 NORTH 18TH STREET, LAFAYETTE, IN 47904
(765) 423-6351
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
IN
Other
Enumeration date
09/29/2006
Last updated
08/22/2020
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