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Nra Fredericktown Missouri Llc
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fredericktown, Missouri
NPI 1639378474

Nra Fredericktown Missouri Llc is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Fredericktown, MO and is specialized in End-Stage Renal Disease (ESRD) Treatment. Nra Fredericktown Missouri Llc practices in Fredericktown, MO. The NPI Number for Nra Fredericktown Missouri Llc is 1639378474 and holds a License No. NOT APPLICABLE (Missouri).

The current practice location address for Nra Fredericktown Missouri Llc is 105 Armory Street, Fredericktown, MO and can be reached out via phone at 573-783-2089 and via fax at 573-783-7206.

Location: 105 Armory Street, Fredericktown, MO, 63645-1340
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1639378474
Provider Name
Nra Fredericktown Missouri Llc
Credential
Provider Entity Type
Organization
Address
105 Armory Street, Fredericktown, MO, 63645-1340
Phone Number
573-783-2089
Fax Number
573-783-7206
Provider Enumeration Date
07/12/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
26D1071779 01 MO CLIA CERT. OF WAIVER
504928904 05 MO
institution
Provider Business Practice Location Address Details
Address
105 Armory Street
City
Fredericktown
State
Missouri
Zip
63645-1340
Phone Number
573-783-2089
Fax Number
573-783-7206
person
Provider Business Mailing Address Details
Address
105 Armory Street
City
Fredericktown
State
Missouri
Zip
63645-1340
Phone Number
573-783-2089
Fax Number
573-783-7206
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.
NOT APPLICABLE (Missouri)
Definition
Definition to come...
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