Organization
ADVANCE MOBILE DIALYSIS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DON ARNETT COOK JR. RT (OWNER/PRESIDENT)
(318) 423-0159
Entity
Organization
Contact information
Practice address
2054 BERMUDA ST, SHREVEPORT, LA 71105-3802
(318) 349-1826
Mailing address
2054 BERMUDA ST, SHREVEPORT, LA 71105-3802
(318) 349-1826
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
10812630#5PK73
LA
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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