Organization
LIFELINE RENAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIJU KURIAKOSE (CEO)
(972) 859-9996
Entity
Organization
Contact information
Practice address
4309 RIDGECREST RD STE 100, GREENVILLE, TX 75402-6003
(972) 859-9996
Mailing address
2517 SCOTTI ST, LEWISVILLE, TX 75056-5882
(972) 859-9996
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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