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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