Historic Dialysis LLC
NPI #1457599722 in Forrest City, Arkansas
Provider Information
- NPI Number
- 1457599722
- Entity Type
- Organization
- Organization Name
- Historic Dialysis LLC
- Primary Specialty
- Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
- Enumeration Date
- Jan 26, 2009
- Last Updated
- Oct 29, 2009
Practice Location
- Address
- 1501 N WASHINGTON ST
- City
- Forrest City
- State
- Arkansas
- ZIP Code
- 72335-2152
- Phone
- (870) 494-4022
Authorized Official
- Name
- JAMES K HILGER
- Title
- VICE PRESIDENT
- Phone
- (253) 382-1919
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment |
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