Provider Demographics
NPI:1023328671
Name:PATIENTS FIRST DIALYSIS OF BREWTON
Entity type:Organization
Organization Name:PATIENTS FIRST DIALYSIS OF BREWTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:EVERATT
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-609-3321
Mailing Address - Street 1:1205 BELLEVILLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-1304
Mailing Address - Country:US
Mailing Address - Phone:251-867-3606
Mailing Address - Fax:
Practice Address - Street 1:1205 BELLEVILLE AVENUE
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-1304
Practice Address - Country:US
Practice Address - Phone:251-867-3606
Practice Address - Fax:251-867-3606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment