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General NPI Number Information
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NPI Number | 1679712814
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Entity Type | Organization
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Legal Business Name | WARREN DIALYSIS CENTER LLC
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 01/11/2023
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Provider Practice Location Address
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Address Line | 8720 E MARKET ST SUITE 1A
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City | WARREN
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State | OH
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Zip | 44484-2364
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Country | US
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Telephone | 330-609-5502
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Fax | 330-609-5505
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Provider Business Mailing Address
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Address Line | 8720 E MARKET ST SUITE 1A
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City | WARREN
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State | OH
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Zip | 44484-2364
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Country | US
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Telephone | 330-609-5502
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Fax | 330-609-5505
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Authorized Official
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Title or Position | CHIEF NURSING OFFICER
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Name | SARA ANNE BRADY
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Credential |
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Telephone | 208-371-7878
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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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