Organization
PURITY DIALYSIS CENTERS, INC
Active
Other names
Germantown Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA M WALDRON (BILLING SUPERVISOR)
(262) 646-6426
Entity
Organization
Contact information
Practice address
W175 N11056 STONEWOOD DR., GERMANTOWN, WI 53022
(262) 646-6426
(262) 646-2498
Mailing address
2301 SUN VALLEY DR STE 200, DELAFIELD, WI 53018-2318
(262) 646-6426
(262) 646-2498
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831315845
—
WI
01
—
52D1089424
CLIA ID NUMBER
WI
Enumeration date
04/18/2007
Last updated
10/28/2016
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