Organization
DIALYSIS AFFILIATES OF SOUTH ALABAMA
Active
Organization
DIALYSIS AFFILIATES OF SOUTH ALABAMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES D. RAULERSON M.D. (CEO)
(251) 867-3650
Entity
Organization
Contact information
Practice address
1205 BELLEVILLE AVE, BREWTON, AL 36426-1304
(251) 867-3650
(251) 867-3610
Mailing address
1205 BELLEVILLE AVE, BREWTON, AL 36426-1304
(251) 867-3650
(251) 867-3610
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
10749
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264DAS
BC/BS OF ALABAMA
AL
05
—
DIA2549D
—
AL
Enumeration date
11/14/2005
Last updated
04/29/2011
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