WATERTOWN DIALYSIS CENTER LLC NPI 1710368618

NPI Information

WATERTOWN DIALYSIS CENTER, LLC is an end-stage renal disease (esrd) treatment clinic center in Watertown, NY. WATERTOWN DIALYSIS CENTER, LLC NPI is 1710368618. The provider is registered as an organization entity type.
The provider Is Doing Business As Watertown Dialysis Center.

The provider's business location address is:

22571 SUMMIT DR
WATERTOWN, NY
ZIP 13601-233
Phone: (315) 779-2140
Fax: (315) 779-2145

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 33D1067235 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2015 and was last updated on 8/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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