Organization
SOUTHWEST KIDNEY DIALYSIS, LLC
Active
Organization
SOUTHWEST KIDNEY DIALYSIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MAUVAIS (CHEIF FINANCIAL OFFICER)
(480) 610-6110
Entity
Organization
Contact information
Practice address
20325 N 51ST AVE, BUILDING 11, SUITE 186, GLENDALE, AZ 85308-5674
(623) 533-6521
(623) 533-6579
Mailing address
2149 E WARNER RD, STE 112, TEMPE, AZ 85284-3494
(480) 610-6100
(480) 610-6195
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
04/19/2007
Last updated
09/24/2007
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