Organization
DIALYSIS CENTERS OF ARKANSAS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD EDWARD EDGERTON (ADMINISTRATOR)
(501) 955-1156
Entity
Organization
Contact information
Practice address
4509 E MCCAIN BLVD, NORTH LITTLE ROCK, AR 72117-2902
(501) 945-8080
(501) 945-5040
Mailing address
4509 EAST MCCAIN BLDV., NORTH LITTLE ROCK, AR 72117
(501) 945-8080
(501) 945-5040
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
MC2029
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E042548
MEDICARE FACILITY NUMBER
AR
01
—
E042559
MEDICARE FACILITY NUMBER
AR
Enumeration date
10/11/2006
Last updated
08/22/2020
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