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General NPI Number Information
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NPI Number | 1841621356
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Entity Type | Organization
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Legal Business Name | DSI ALTUS, LLC
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Dates
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Enumeration Date | 12/09/2013
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 1401 E BROADWAY ST
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City | ALTUS
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State | OK
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Zip | 73521-5705
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Country | US
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Telephone | 615-234-0951
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Fax |
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Provider Business Mailing Address
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Address Line | 424 CHURCH ST SUITE 1900
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City | NASHVILLE
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State | TN
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Zip | 37219-2301
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Country | US
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Telephone | 615-777-8200
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | THOMAS L. WEINBERG
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Credential |
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Telephone | 214-736-2700
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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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