OrganizationActive
Southeastern Renal Dialysis L.c.
NPI 1609988617 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fort Madison, IA
Provider details
- NPI number
- 1609988617
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Southeastern Renal Dialysis L.c.
- Organization subpart
- Yes
- Authorized official
- Mary Liechty, Administrator(319) 385-6728
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
4703 Avenue L
Fort Madison, IA 52627-9505
Phone: (319) 372-7996
Approximate (ZIP-level) locationGet directions
Mailing address
507 S White St
Mt Pleasant, IA 52641-2625
Registry dates
- Enumerated
- 2006-08-31
- Last updated
- 2012-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.