| NPI | 1457529943 |
|---|---|
| Doing Business As | CKD SERVICES OF EVERGREEN PARK |
| Entity Type | Organization |
| Authorized Contact | MARK FAWCETT Vice President, Treasurer 781-699-2668 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |