Organization
WEST PENSACOLA DIALYSIS LLC
Active
Other names
West Pensacola Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JIM HILGER (VICE PRESIDENT)
(253) 382-1919
Entity
Organization
Contact information
Practice address
598 N FAIRFIELD DR, PENSACOLA, FL 32506-4320
(852) 453-6066
(850) 453-6681
Mailing address
5200 VIRGINIA WAY, STE 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4521
(866) 317-5894
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
—
000094300
—
FL
Enumeration date
03/19/2007
Last updated
11/12/2008
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