Organization
PURITY DIALYSIS CENTERS INC
Active
Other names
Purity Home Training Program
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA M WALDRON (BILLING SUPERVISOR)
(262) 646-6426
Entity
Organization
Contact information
Practice address
2301 SUN VALLEY DR STE 101, DELAFIELD, WI 53018-2318
(262) 646-6426
(262) 646-2498
Mailing address
2301 SUN VALLEY DR STE 200, DELAFIELD, WI 53018-2318
(262) 646-6426
(262) 646-2498
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
05
—
1669650545
—
WI
01
—
52D1091140
CLIA ID NUMBER
WI
Enumeration date
02/04/2008
Last updated
10/28/2016
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