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General NPI Number Information
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NPI Number | 1023070273
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Entity Type | Organization
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Legal Business Name | PAUKERT DIALYSIS INC
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 TRANCAS ST SUITE #267
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City | NAPA
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State | CA
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Zip | 94558
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Country | US
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Telephone | 707-224-6533
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Fax | 707-224-6535
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Provider Business Mailing Address
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Address Line | 1100 TRANCAS ST SUITE #267
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City | NAPA
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State | CA
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Zip | 94558
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Country | US
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Telephone | 707-224-6533
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Fax | 707-224-6535
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Authorized Official
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Title or Position | OWNER ADMINISTRATOR
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Name | MRS. SHERYLE E PAUKERT
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Credential | RN NP
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Telephone | 707-224-6533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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