Organization
ISD RENAL INC
Active
Organization
ISD RENAL INC
Active
Other names
Hazlehurst Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
201 N HALEY ST, HAZLEHURST, MS 39083
(601) 894-5509
(601) 894-5514
Mailing address
5200 VIRGINIA WAY, L & C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4268
(877) 238-0567
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
—
00220481
—
MS
Enumeration date
05/24/2006
Last updated
07/30/2018
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