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General NPI Number Information
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NPI Number | 1861535833
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Entity Type | Organization
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Legal Business Name | FIRST COAST DIALYSIS CENTER
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1308 SE 25TH LOOP STE 102
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City | OCALA
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State | FL
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Zip | 34471-1028
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Country | US
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Telephone | 352-732-1634
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Fax | 352-732-0391
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Provider Business Mailing Address
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Address Line | 1308 SE 25TH LOOP STE 102
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City | OCALA
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State | FL
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Zip | 34471
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Country | US
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Telephone | 352-732-1634
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Fax | 352-732-0391
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Authorized Official
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Title or Position | PATIENT ACCOUNTS REPRESENTATIVE
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Name | MS. SHERRY LYNN VANDERHOOF
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Credential |
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Telephone | 352-732-1634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number |
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License Number State | FL
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