Organization
DIALYSIS MANAGEMENT GROUP LLC
Active
Organization
DIALYSIS MANAGEMENT GROUP LLC
Active
Other names
Porcupine Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLEN RADA (PRESIDENT)
(605) 390-0910
Entity
Organization
Contact information
Practice address
HCR 49, PORCUPINE, SD 57772-0000
(605) 718-0392
Mailing address
HCR 49 BOX 82C, PORCUPINE, SD 57772-0000
(605) 718-0392
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
—
5400390
—
SD
Enumeration date
10/15/2010
Last updated
11/22/2013
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