Organization
SOUTHERN COLORADO JOINT VENTURES LLC
Active
Other names
Fountain Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 280-9501
Entity
Organization
Contact information
Practice address
6910 BANDLEY DR, FOUNTAIN, CO 80817
(719) 393-0190
(719) 393-0318
Mailing address
5200 VIRGINIA WAY, BRENTWOOD, TN 37027-7569
(615) 341-5893
(877) 850-7073
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
—
22570781
—
CO
Enumeration date
07/11/2006
Last updated
03/04/2015
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