Provider Demographics
NPI:1881738524
Name:DIALYSIS ACCESS CENTER PLC
Entity type:Organization
Organization Name:DIALYSIS ACCESS CENTER PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-949-3845
Mailing Address - Street 1:16507 SOUTHFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2503
Mailing Address - Country:US
Mailing Address - Phone:313-389-0648
Mailing Address - Fax:313-389-3510
Practice Address - Street 1:16507 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2503
Practice Address - Country:US
Practice Address - Phone:313-389-0648
Practice Address - Fax:313-389-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty