Organization
AMERICAN RED CROSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WALLY L THOMAS MT, ASCP (MANAGER, CLINICAL SERVICES)
(573) 449-2656
Entity
Organization
Contact information
Practice address
1511 S PROVIDENCE RD, COLUMBIA, MO 65203-3535
(573) 449-2656
(573) 443-3831
Mailing address
1511 S PROVIDENCE RD, COLUMBIA, MO 65203-3535
(573) 449-2656
(573) 443-3831
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
26D0652375
MO
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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