| NPI | 1952356453 |
|---|---|
| Doing Business As | NEOMEDICAL EVERGREEN PARK |
| Entity Type | Organization |
| Authorized Contact | MARK FAWCETT Treasurer 781-699-2668 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2008-05-28 |