Organization
HOME DIALYSIS SERVICES CARROLLWOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORUFU OLATUNJI ALAUSA MD (CHIEF MEDICAL DIRECTOR)
(815) 741-6830
Entity
Organization
Contact information
Practice address
4218 W LINEBAUGH AVE, TAMPA, FL 33624-5241
(813) 461-5700
Mailing address
PO BOX 3134, JOLIET, IL 60434-3134
(815) 714-7171
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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