Organization
SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC
Active
Other names
Power Road Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
301 S POWER RD, STE 104, MESA, AZ 85206-5243
(480) 641-1193
(480) 807-3388
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6814
(800) 293-8405
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
—
805318
—
AZ
Enumeration date
07/31/2012
Last updated
04/21/2023
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