Organization
CLEVELAND NEPHROLOGISTS, PLLC
Active
Other names
Home Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSWALD LLANDEROSOS MD (OWNER/MEMBER)
(405) 329-3830
Entity
Organization
Contact information
Practice address
1059 SE 82ND, OKLAHOMA CITY, OK 73149-2902
(405) 329-3830
(405) 329-3791
Mailing address
1561 N. PORTER AVE, NORMAN, OK 73071-6621
(405) 329-3830
(405) 329-3791
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
01
—
37-2579
MEDICARE PROVIDER NUMBER
OK
Enumeration date
01/07/2010
Last updated
11/02/2010
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