institution
Lake Norman Dialysis Center Of Wake Forest University
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Mooresville, North Carolina
NPI 1134106198

Lake Norman Dialysis Center Of Wake Forest University is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Tifton, NC and is specialized in End-Stage Renal Disease (ESRD) Treatment. Lake Norman Dialysis Center Of Wake Forest University practices in Mooresville, NC. The NPI Number for Lake Norman Dialysis Center Of Wake Forest University is 1134106198 and holds a License No. (North Carolina).

The current practice location address for Lake Norman Dialysis Center Of Wake Forest University is 164 Professional Park Dr, Mooresville, NC and can be reached out via phone at 704-799-1860 and via fax at 704-799-1867. You can also correspond with Lake Norman Dialysis Center Of Wake Forest University through the mailing address at PO BOX 7710, TIFTON, GA - 31793-7710 (mailing address contact number: 229-387-3527).

Location: 164 Professional Park Dr, Mooresville, NC, 31793-7710
institution
Provider Profile Details
NPI Number
1134106198
Provider Name
Lake Norman Dialysis Center Of Wake Forest University
Credential
Provider Entity Type
Organization
Address
164 Professional Park Dr, Mooresville, NC, 31793-7710
Phone Number
704-799-1860
Fax Number
704-799-1867
Provider Enumeration Date
12/29/2005
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
3402606 05 NC
00060 01 NC BCBS-NC
institution
Provider Business Practice Location Address Details
Address
164 Professional Park Dr
City
State
Zip
28117-5537
Phone Number
704-799-1860
Fax Number
704-799-1867
person
Provider Business Mailing Address Details
Address
164 Professional Park Dr
City
State
Zip
28117-5537
Phone Number
704-799-1860
Fax Number
704-799-1867
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
License No.
(North Carolina)
Definition
Definition to come...
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