Organization
PHOENIX PEDIATRIC DIALYSIS CENTER LLC
Active
Organization
PHOENIX PEDIATRIC DIALYSIS CENTER LLC
Active
Other names
Pediatric Dialysis Center of Phoenix
Organization subpart
No
Provider details
NPI number
Authorized official
SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY)
(978) 922-3080
Entity
Organization
Contact information
Practice address
2545 E THOMAS RD, SUITE 100, PHOENIX, AZ 85016-7969
(602) 957-1648
(602) 957-2196
Mailing address
2545 E THOMAS RD, SUITE 100, PHOENIX, AZ 85016-7969
(602) 957-1648
(602) 957-2196
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/12/2016
Last updated
03/12/2020
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