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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