Organization
FORT SMITH REGIONAL DIALYSIS CENTER, LLC
Active
Other names
Poteau Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA PALMER (EXECUTIVE DIRECTOR)
(479) 755-6700
Entity
Organization
Contact information
Practice address
1200 CENTRAL ST, POTEAU, OK 74953-2320
(918) 647-9373
Mailing address
2201 BROOKEN HILL DR, FORT SMITH, AR 72908-8611
(479) 755-6700
(479) 755-6704
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
—
100707620A
—
OK
05
—
146670734
—
OK
01
—
900522191
PHYSICIAN'S
OK
Enumeration date
05/23/2005
Last updated
06/13/2012
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