Logan Dialysis Center LLC

NPI #1407030802 in Logan, Ohio

Provider Information

NPI Number: 1407030802
Entity Type: Organization
Organization Name: Logan Dialysis Center LLC
Primary Specialty: Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
Enumeration Date: Dec 20, 2007
Last Updated: Dec 20, 2007

Practice Location

Address: 12900 STATE ROUTE 664 S
City: Logan
State: Ohio
ZIP Code: 43138-9261
Phone: (740) 385-6300

Authorized Official

Name: MR. CHRISTOPHER T FORD
Title: CHAIRMAN
Phone: (978) 922-3080

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment	261QE0700X	Primary

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