| NPI | 1003921842 |
|---|---|
| Doing Business As | PORTAGE DIALYSIS CENTER |
| Entity Type | Organization |
| Authorized Contact | MARK FAWCETT Treasurer 781-402-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |