Provider Demographics
NPI:1588200398
Name:PRIORITY DIALYSIS, INC.
Entity Type:Organization
Organization Name:PRIORITY DIALYSIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-224-0383
Mailing Address - Street 1:2500 E HALLANDALE BEACH BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4835
Mailing Address - Country:US
Mailing Address - Phone:954-800-0953
Mailing Address - Fax:954-800-0953
Practice Address - Street 1:2500 E HALLANDALE BEACH BLVD STE 207
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4835
Practice Address - Country:US
Practice Address - Phone:954-800-0953
Practice Address - Fax:954-800-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment