Basic Information
| Provider Information | |||||||||
| NPI: | 1205274735 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AKDHC, LLC | ||||||||
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| OtherOrganizationName: | ARIZONA KIDNEY DISEASE & HYPERTENSION CENTER | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3003 N CENTRAL AVE STE 400 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850122929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029970484 | ||||||||
| FaxNumber: | 6029446882 | ||||||||
| Practice Location | |||||||||
| Address1: | 6638 E BASELINE RD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852064432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029970484 | ||||||||
| FaxNumber: | 6029446882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2013 | ||||||||
| LastUpdateDate: | 06/06/2013 | ||||||||
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| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 6023513015 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.