Organization
TYLER DIALYSIS LLC
Active
Other names
Lourdes Camden Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
1601 HADDON AVE, CAMDEN, NJ 08103-3109
(856) 541-0647
(856) 541-2698
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6410
(888) 662-8259
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
24696
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0335991
—
NJ
Enumeration date
09/06/2012
Last updated
01/11/2023
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