| NPI | 1386690907 |
|---|---|
| Former Legal Business Name | TRI STATE DIALYSIS CENTER |
| Entity Type | Organization |
| Authorized Contact | ALEX C. TOWN CFO 509-758-4667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment (Licence: WA H-108) |
| Additional Taxonomies | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-08-04 |