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General NPI Number Information
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NPI Number | 1588200398
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Entity Type | Organization
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Legal Business Name | PRIORITY DIALYSIS, INC.
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 2500 E HALLANDALE BEACH BLVD STE 207
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4835
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Country | US
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Telephone | 954-800-0953
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Fax | 954-800-0953
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Provider Business Mailing Address
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Address Line | 2500 E HALLANDALE BEACH BLVD STE 207
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4835
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Country | US
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Telephone | 954-800-0953
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Fax | 954-800-0953
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | WENDY WOODS
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Credential |
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Telephone | 754-224-0383
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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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