| NPI | 1508825704 |
|---|---|
| Doing Business As | MOULTRIE DIALYSIS CENTER |
| Entity Type | Organization |
| Authorized Contact | JOHN D WINSTEL Chief Accounting Officer 253-733-4501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: GA ESRD001016) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2020-04-20 |