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General NPI Number Information
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NPI Number | 1184008856
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Entity Type | Organization
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Legal Business Name | FLINT HILLS DIALYSIS OF JUNCTION CITY
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 1110 SAINT MARYS RD STE 101
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City | JUNCTION CITY
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State | KS
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Zip | 66441-4176
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Country | US
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Telephone | 785-565-9500
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Fax | 785-565-9595
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Provider Business Mailing Address
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Address Line | 1133 COLLEGE AVE B100
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City | MANHATTAN
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State | KS
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Zip | 66502-2770
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Country | US
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Telephone | 785-565-9500
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Fax | 785-565-9595
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. IMAD BEDROS
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Credential |
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Telephone | 785-565-9500
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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 | KS
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