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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