Organization
LIFELINE DIALYSIS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BETTY JEAN VERBAL (ADMIN./CEO)
(954) 676-5488
Entity
Organization
Contact information
Practice address
3601 W COMMERCIAL BLVD, #35, FT LAUDERDALE, FL 33309-3300
(954) 676-5488
(954) 676-5560
Mailing address
3601 W COMMERCIAL BLVD, #35, FT LAUDERDALE, FL 33309-3300
(954) 676-5488
(954) 676-5560
Taxonomy
Speciality
Code
Description
License number
State
332BD1200X
Dialysis Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1257170001
MEDICARE PROVIDER NUMBER
FL
Enumeration date
10/06/2008
Last updated
10/06/2008
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