COMMUNITY DIALYSIS CENTER LLC
Osteopathic Medicine at Campus Dr, Sierra Vista, AZ

License number
Arizona 5215
Category
Osteopathic Medicine
Type
Nephrology
Owner
Name: LUCY BURCIAGA MD
Title: OWNER CEO
Phone: (520) 459-5959
Address
Address
4525 Campus Dr, Sierra Vista, AZ 85635
National Provider ID: 1861580086
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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COMMUNITY DIALYSIS CENTER, LLC

Sierra Vista, AZ

Status:
Inactive
Industry:
Individual/Family Services, Nonclassifiable Establishments
Inactive reason:
Ad-dissolved-maintain stat agent
Registration:
Jul 19, 2006
Inactive since:
Nov 7, 2014
Addresses:
4576 Paseo Brazos Dr, Sierra Vista, AZ 85635 (Physical)
4525 Campus Dr, Sierra Vista, AZ 85635
State ID:
L-1299090-8
Expiration:
PERPETUAL
Osteopathys:
Lucy Burciaga (Manager, Principal, Medical Doctor), 4576 Paseo Brazos Dr, Sierra Vista, AZ 85635 (Physical),Perba Biaswas (Principal),Michael J. Milazzo (Osteopathy)

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