Organization
ELGIN DIALYSIS LLC
Active
Other names
Fort Stockton Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
387 INTERSTATE 10 W, STE C, FORT STOCKTON, TX 79735-2700
(432) 336-8041
(432) 336-8205
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6764
(833) 781-6999
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110157
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028106
KIDNEY CARE
TX
05
—
311318501
—
TX
Enumeration date
06/01/2012
Last updated
04/09/2019
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