| NPI | 1922057421 |
|---|---|
| Doing Business As | CENTRACARE KIDNEY PROGRAM - STAPLES DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL A. BLAIR Sr. Vice President And CFO 320-255-5665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Additional Taxonomies | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: MN 331506) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2019-10-10 |