Organization
HARRISON 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
1409 GLADDEN ST, HARRISON, AR 72601-2236
(870) 204-6683
(870) 204-6686
Mailing address
1409 GLADDEN ST, HARRISON, AR 72601-2236
(870) 204-6683
(870) 204-6686
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
01
—
1659522076
BLUE CROSS
AR
05
—
1659522076
—
MO
05
—
176925134
—
AR
Enumeration date
10/03/2008
Last updated
06/09/2009
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