NPI | 1750340816 |
---|---|
Doing Business As | LAKE CHARLES SOUTH DIALYSIS |
Entity Type | Organization |
Authorized Contact | THOMAS O USILTON Group Vice President 770-541-7922 |
Organization Subpart ? | No |
Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: LA 091) |
Enumeration Date | 2006-03-18 |
Last Update Date | 2007-07-11 |