Organization
PHYSICIANS CHOICE DIALYSIS OF SELMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA PALUMBO (ASST SECRETARY ASST TREAURER)
(610) 495-8900
Entity
Organization
Contact information
Practice address
201 LINCOLN LN, SELMA, AL 36701-7748
(334) 875-5436
(334) 872-8547
Mailing address
PO BOX 534421, ATLANTA, GA 30353-4421
(610) 495-8900
(610) 495-8560
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
S2403
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012-438
BLUE CROSS ALABAMA
AL
05
—
DIA2614D
—
AL
Enumeration date
11/24/2006
Last updated
09/27/2007
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