Provider Demographics
NPI:1063807634
Name:VERITAS DIALYSIS INC.
Entity type:Organization
Organization Name:VERITAS DIALYSIS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MORUFU
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-741-6830
Mailing Address - Street 1:PO BOX 3134
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60434-3134
Mailing Address - Country:US
Mailing Address - Phone:815-741-6830
Mailing Address - Fax:815-435-5080
Practice Address - Street 1:5329 MEMORIAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3212
Practice Address - Country:US
Practice Address - Phone:678-262-4181
Practice Address - Fax:678-262-4182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment