Physicians Choice Dialysis of Jacksonville, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

PHYSICIANS CHOICE DIALYSIS OF JACKSONVILLE, LLC

Practice address

331 Henry Road SW
Jacksonville, AL 36265

Phone

(610) 495-8900

Fax

(610) 495-8560

NPI assigned

Jan 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Rhonda B Palumbo

Title

Director of Contracts/HR

Phone

(610) 495-8900

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254441600000",
    "number": "1386829489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 COMMERCE CT",
            "address_2": "SUITE 104",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643483",
            "telephone_number": "610-495-8900",
            "fax_number": "610-495-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 HENRY ROAD SW",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "36265",
            "telephone_number": "610-495-8900",
            "fax_number": "610-495-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CHOICE DIALYSIS OF JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2009-10-02",
        "status": "A",
        "authorized_official_last_name": "PALUMBO",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTS/HR",
        "authorized_official_telephone_number": "610-495-8900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DIA2625D",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reggie Ardale Parker Sr., LPC
• Morgan Brittany Pentecost, PHARMD
• Courtney S Peppers-Owen, BCBA
• Jacob Louis Phillips
• Physician Services of Alabama LLC
• Adam Pike, PHARM.D
• Michael Garrett Polascik, ATC
• Maranda L Posey, FNP-BC
• Gavyn Prat
• Premier Hearing

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Jacksonville, AL
• Providers in Jacksonville, AL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.