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General NPI Number Information
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NPI Number | 1821675711
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Entity Type | Organization
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Legal Business Name | FRESENIUS MEDICAL CARE HOLLIDAY DIALYSIS, LLC
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 1104 HOLLIDAY ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4422
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Country | US
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Telephone | 940-386-9611
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Fax | 940-386-9645
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Provider Business Mailing Address
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Address Line | 1104 HOLLIDAY ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4422
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Country | US
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Telephone | 940-386-9611
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Fax | 940-386-9645
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Authorized Official
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Title or Position | SUPERVISOR
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Name | AMBER EKRE
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Credential |
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Telephone | 480-284-3996
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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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