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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