Organization
SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Active
Organization
SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Active
Other names
Phoenix Home Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O USILTON JR. (SR VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
20325 N 51ST AVE, BLDG 11 STE 184, GLENDALE, AZ 85308-5674
(623) 533-3836
(623) 533-4033
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4435
(303) 209-7821
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/27/2007
Last updated
01/10/2008
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