Organization
EL CAMPO DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ANNE TIMMONS (ADMINISTRATOR)
(979) 543-8200
Entity
Organization
Contact information
Practice address
307 SANDY CORNER RD, EL CAMPO, TX 77437-9535
(979) 543-8200
Mailing address
307 SANDY CORNER RD, EL CAMPO, TX 77437-9535
(979) 543-8200
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
NOT CERTIFIED
TX
Enumeration date
07/06/2009
Last updated
10/19/2009
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