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Wallowa Dialysis Llc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Ontario, Ohio
NPI 1023360955

Wallowa Dialysis Llc is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Brentwood, OH and is specialized in End-Stage Renal Disease (ESRD) Treatment. Wallowa Dialysis Llc practices in Ontario, OH. The NPI Number for Wallowa Dialysis Llc is 1023360955 and holds a License No. (Ohio).

The current practice location address for Wallowa Dialysis Llc is 2148 W 4Th St, Ontario, OH and can be reached out via phone at 419-747-4039 and via fax at 419-747-4046.

Location: 2148 W 4Th St, Ontario, OH, 37027-7569
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1023360955
Provider Name
Wallowa Dialysis Llc
Credential
Provider Entity Type
Organization
Address
2148 W 4Th St, Ontario, OH, 37027-7569
Phone Number
419-747-4039
Fax Number
419-747-4046
Provider Enumeration Date
10/02/2012
Last Update Date
10/19/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0100014 05 OH
institution
Provider Business Practice Location Address Details
Address
2148 W 4Th St
City
Ontario
State
Ohio
Zip
44906-1200
Phone Number
419-747-4039
Fax Number
419-747-4046
person
Provider Business Mailing Address Details
Address
2148 W 4Th St
City
Ontario
State
Ohio
Zip
44906-1200
Phone Number
419-747-4039
Fax Number
419-747-4046
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
261QE0700X
License No.
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Definition
Definition to come...
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