Organization
MEDI-SYSTEM RENAL CARE MANAGEMENT SERVICES LLC
Active
Other names
hollis dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARAUDY ROGER ANTOINE (PRESIDENT / ADMINISTRATOR)
(516) 473-3762
Entity
Organization
Contact information
Practice address
18230 JAMAICA AVE, HOLLIS, NY 11423-2328
(516) 473-3762
Mailing address
18230 JAMAICA AVE, HOLLIS, NY 11423-2328
(516) 473-3762
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
202469
NY
Other
Enumeration date
06/30/2013
Last updated
06/30/2013
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