Evanston Hospital Corporation

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1255304051

Evanston Hospital Corporation is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Evanston, Wyoming. Licensed in Wyoming. Registered with an NPI since 2006.

Licensed in: WY
In the registry since: 2006

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Practice location Address checks out

112 Yellow Creek Rd
Evanston, WY 82930-9266
Phone: (307) 789-3636

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary)	Taxonomy 261QE0700X · Licence 06-102 (WY)

Record details

NPI number	1255304051
Entity type	Organization (Type 2)
Organization subpart	Yes
Parent organization	Evanston Hospital Corporation
Authorized official	Randy Cooper — Svp Finance Operations/Ao · (615) 221-3840
Other names	Evanston Dialysis Center; Evanston Dialysis Center
NPI enumerated	February 10, 2006
Last updated in NPPES	September 3, 2020
Certification date	September 3, 2020
Mailing address	190 Arrowhead Dr, Evanston, WY 82930-9266