Healthcare Provider Details

I. General information

NPI: 1356517916
Provider Name (Legal Business Name): PHYSICIANS CHOICE DIALYSIS OF CALHOUN COUNTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 KEITH AVENUE
ANNISTON AL
36207
US

IV. Provider business mailing address

211 COMMERCE COURT SUITE 104
POTTSTOWN PA
19464
US

V. Phone/Fax

Practice location:
  • Phone: 256-235-2213
  • Fax:
Mailing address:
  • Phone: 610-495-8900
  • Fax: 610-495-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number StateAL

VIII. Authorized Official

Name: THOMAS J KARL
Title or Position: MEMBER/MANAGER
Credential:
Phone: 610-495-8900