Organization
INDEPENDENT DIALYSIS SERVICES, INC
Active
Organization
INDEPENDENT DIALYSIS SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERANCE TAYLOR (OFFICE MANAGER)
(504) 914-3625
Entity
Organization
Contact information
Practice address
2900 ELYSIAN FIELDS AVE, SUITE B, NEW ORLEANS, LA 70122-3625
(504) 947-3625
(504) 947-3675
Mailing address
2900 ELYSIAN FIELDS AVE, SUITE B, NEW ORLEANS, LA 70122-3625
(504) 947-3625
(504) 947-3675
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
05
—
1436356
—
LA
01
—
30345
BLUE CROSS PROVIDER NUMBE
LA
Enumeration date
08/26/2005
Last updated
08/22/2020
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