Organization
RITA RANCH DIALYSIS LLC
Active
Other names
Rita Ranch Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
7355 S HOUGHTON RD STE 101, TUCSON, AZ 85747-9380
(520) 663-4035
(520) 663-3826
Mailing address
5200 VIRGINIA WAY, L&C DEPT., BRENTWOOD, TN 37027-7569
(615) 341-5895
(866) 890-5560
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
OTC4770
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524427
—
AZ
01
—
OTC4770
STATE LICENSE
AZ
Enumeration date
01/14/2009
Last updated
01/16/2015
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