OrganizationActive
Kidney Replacement Therapies, Sc
NPI 1720283302 · End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Kenosha, WI
Provider details
- NPI number
- 1720283302
- Entity type
- Organization
- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ganesh Pulla, Doctor(262) 564-8636
- License
- 40695-20 (WI)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
6125 Green Bay Rd
Suite 100
Kenosha, WI 53142-2928
Phone: (262) 564-8636
Fax: (262) 564-8637
Approximate (ZIP-level) locationGet directions
Mailing address
6125 Green Bay Rd
Kenosha, WI 53142-2928
Registry dates
- Enumerated
- 2007-06-15
- Last updated
- 2014-12-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.