Organization
DIALYSIS CARE CENTER OF PALM COAST LLC
Active
Organization
DIALYSIS CARE CENTER OF PALM COAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARI COUSINS (SR. VP OF CLINICAL & REGULATORY)
(978) 922-3080
Entity
Organization
Contact information
Practice address
515 PALM COAST PKWY SW, UNITS 2, 3, & 4, PALM COAST, FL 32137-5700
(386) 447-4477
(386) 447-4476
Mailing address
515 PALM COAST PARKWAY SW, UNITS 2, 3, 4, PALM COAST, FL 32137-5700
(386) 447-4477
(386) 447-4476
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/21/2007
Last updated
03/10/2020
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