NATIONAL ANCILLARY PROVIDER NETWORK January 2019 TABLE OF CONTENTS Alabama ....................................................... 3 South Dakota.............................................. 98 Alaska........................................................... 5 Tennessee.................................................. 98 Arizona ......................................................... 5 Texas........................................................ 101 Arkansas ...................................................... 7 Utah ...........................................................114 California ...................................................... 9 Vermont .....................................................115 Colorado ..................................................... 22 Virginia ......................................................115 Connecticut ................................................ 25 Washington ...............................................118 Delaware .................................................... 26 Washington D.C. ...................................... 120 Florida ........................................................ 26 West Virginia ............................................ 120 Georgia....................................................... 36 Wisconsin ................................................. 122 Hawaii......................................................... 43 Wyoming .................................................. 124 Idaho .......................................................... 43 Illinois ......................................................... 44 Indiana........................................................ 48 Iowa ............................................................ 52 Kansas ....................................................... 54 Kentucky..................................................... 56 Louisiana .................................................... 58 Maine.......................................................... 60 Maryland..................................................... 60 Massachusetts ........................................... 63 Michigan ..................................................... 64 Minnesota ................................................... 68 Mississippi .................................................. 70 Missouri ...................................................... 71 Montana ..................................................... 73 Nebraska .................................................... 73 Nevada ....................................................... 74 New Hampshire .......................................... 75 New Jersey................................................. 76 New Mexico ................................................ 79 New York .................................................... 79 North Carolina ............................................ 82 North Dakota .............................................. 86 Oklahoma ................................................... 86 Oregon ....................................................... 88 Pennsylvania .............................................. 89 Rhode Island .............................................. 95 South Carolina............................................ 95 This list is based on the latest available information effective January 2019. 1 MEDICAL MUTUAL- NATIONAL ANCILLARY PROVIDER NETWORK COLONEL DIALYSIS DVA HEALTHCARE RENAL CARE INC ALABAMA 1830 LEE AVE SW 1105 E PARK DR CULLMAN AL 35055 BIRMINGHAM AL 35235 ANDALUSIA DIALYSIS (256) 736-9276 (205) 833-6003 757 S THREE NOTCH ST cullman county jefferson county ANDALUSIA AL 36420 (334) 222-1628 dialysis center dialysis center covington county CONVACARE SERVICES INC 409 S 1ST ST GADSDEN AL 35901 dialysis center 1465 S ALABAMA AVE MONROEVILLE AL 36460 (256) 547-2511 ANNISTON DIALYSIS (251) 575-3029 etowah county 1612 NOBLE ST monroe county dialysis center ANNISTON AL 36201 (256) 237-3794 dme suppliers-practice DVA RENAL HLTHCARE INC DAVITA calhoun county 85 BANK ST 14897 HIGHWAY 43 dialysis center STEVENSON AL 35772 RUSSELLVILLE AL 35653 (256) 437-2248 (256) 332-7044 APRIA HEALTHCARE INC jackson county franklin county 100 OXMOOR RD dme suppliers-practice dialysis center BIRMINGHAM AL 35209 (205) 942-4702 CORAM HEALTHCARE CORP OF 331 JAMES PAYTON BLVD SYLACAUGA AL 35150 jefferson county ALABA (256) 249-4994 dme suppliers-practice 300 RIVERHILLS BUSINESS PARK BIRMINGHAM AL 35242 talladega county 4970 RANGELINE RD (205) 995-8117 dialysis center MOBILE AL 36619 (251) 665-5200 shelby county 901 W LAKE MALL home infusion therapy BESSEMER AL 35020 mobile county (205) 424-1848 dme suppliers-practice CRIMSON DIALYSIS jefferson county 6521 HIGHWAY 69 S dialysis center ATHENS DIALYSIS TUSCALOOSA AL 35405 15953 ATHENS LIMESTONE DR (205) 752-3267 ENSLEY DIALYSIS ATHENS AL 35613 (256) 233-4730 tuscaloosa county 2630 AVENUE E dialysis center BIRMINGHAM AL 35218 limestone county (205) 786-1371 dialysis center CROWN DIALYSIS jefferson county 3007 27TH ST N dialysis center ATMORE DIALYSIS CENTER BIRMINGHAM AL 35207 807 E CRAIG ST (205) 297-0143 ENTERPRISE DIALYSIS ATMORE AL 36502 (251) 368-5593 jefferson county 6002 BOLL WEEVIL CIR dialysis center ENTERPRISE AL 36330 escambia county (334) 308-0262 dialysis center DAVITA HOKES BLUFF coffee county 300 MEDICAL CENTER DR dialysis center BARBOUR COUNTY DIALYSIS GADSDEN AL 35903 1218 S EUFAULA AVE (256) 492-4970 EUFAULA DIALYSIS EUFAULA AL 36027 (334) 687-7583 etowah county 220 S ORANGE AVE dialysis center EUFAULA AL 36027 barbour county (334) 688-0806 dialysis center DOTHAN DIALYSIS barbour county 216 GRACELAND DR dialysis center BIRMINGHAM NORTH GAMBRO DOTHAN AL 36305 1917 32ND AVE N (334) 793-4077 FAYETTE DIALYSIS BIRMINGHAM AL 35207 (615) 320-4200 houston county 2450 TEMPLE AVE N dialysis center FAYETTE AL 35555 jefferson county (205) 932-8500 dialysis center DVA HEALTHCARE OF TUSCALOOSA L fayette county 220 15TH ST dialysis center BOAZ DIALYSIS TUSCALOOSA AL 35401 16 CENTRAL HENDERSON RD (205) 345-6004 FLORENCE DIALYSIS BOAZ AL 35957 (256) 840-5931 tuscaloosa county 422 E DR HICKS BLVD dialysis center FLORENCE AL 35630 marshall county (256) 764-5050 dialysis center DVA HEALTHCARE RENAL CARE lauderdale county 2401 HOSPITAL DR dialysis center BREWTON DIALYSIS NORTHPORT AL 35476 1023 DOUGLAS AVE (205) 339-8882 BREWTON AL 36426 (251) 867-8509 tuscaloosa county dialysis center escambia county dialysis center This list is based on the latest available information effective January 2019. — 3 — MEDICAL MUTUAL- NATIONAL ANCILLARY PROVIDER NETWORK GAMBRO HEALTHCARE ASHTABULA 1801 1ST AVE S 2510 VIKING DR 511 S CEDAR AVE BIRMINGHAM AL 35233 JASPER AL 35501 DEMOPOLIS AL 36732 (205) 581-3500 (205) 295-2262 (615) 320-4200 jefferson county walker county marengo county lab-independent dme suppliers-practice dialysis center 2010 BROOKWOOD MEDICAL CTR DR 307 VETERANS DR HOMEWOOD AL 35209 FLORENCE AL 35630 GREENE COUNTY DIALYSIS (205) 877-2113 (256) 768-0404 544 US HIGHWAY 43 EUTAW AL 35462 jefferson county lauderdale county (205) 372-4000 lab-independent dme suppliers-practice greene county 301 GOVERNORS DR SW 3214 9TH AVE SW dialysis center HUNTSVILLE AL 35801 HUNTSVILLE AL 35805 (256) 882-1052 (256) 533-5343 GREYSTONE DIALYSIS madison county madison county 5406 HIGHWAY 280 lab-independent dme suppliers-practice BIRMINGHAM AL 35242 (205) 981-2045 6940 WINTON BLOUNT BLVD 3224 RAINBOW DR MONTGOMERY AL 36117 RAINBOW CITY AL 35906 shelby county (334) 279-9211 (256) 442-1187 dialysis center montgomery county etowah county GULF SHORES DIALYSIS lab-independent dme suppliers-practice 3947 GULF SHORES PKWY 902 DR EDWARD HILLARD DR 3605 SUMMERVILLE RD GULF SHORES AL 36542 TUSCALOOSA AL 35401 PHENIX CITY AL 36867 (251) 967-2205 (205) 758-2794 (334) 298-0070 baldwin county tuscaloosa county russell county dialysis center lab-independent dme suppliers-practice HENRY COUNTY DIALYSIS LEEDS DIALYSIS 710 BELVEDERE DR 671 OZARK RD 1650 MAXEY DR ANDALUSIA AL 36420 ABBEVILLE AL 36310 LEEDS AL 35094 (334) 222-0050 (334) 585-0131 (206) 699-5383 covington county henry county st. clair county dme suppliers-practice dialysis center dialysis center 8154 STATE HIGHWAY 59 HOME DIALYSIS OPTIONS BALDWIN FOLEY AL 36535 LINCARE INC (251) 970-3900 27880 N MAIN ST 104 EXECUTIVE PARK LN baldwin county DAPHNE AL 36526 SELMA AL 36701 (251) 626-1086 (334) 874-7743 dme suppliers-practice baldwin county dallas county 880 GILLESPIE ST dialysis center dme suppliers-practice PRATTVILLE AL 36067 (334) 358-4332 HOME OPTIONS OF DOTHAN 1101 GENEVA ST autauga county OPELIKA AL 36801 1763 E MAIN ST dme suppliers-practice DOTHAN AL 36301 (334) 745-5225 (334) 673-0246 lee county 930 KEITH AVE houston county dme suppliers-practice ANNISTON AL 36207 dialysis center (256) 240-7215 1218 S BRUNDIDGE ST calhoun county JEWEL DIALYSIS TROY AL 36081 (334) 566-1086 dme suppliers-practice 514 W TOWN PLZ 935 HIGHWAY 431 BESSEMER AL 35020 pike county dme suppliers-practice ROANOKE AL 36274 (205) 481-4386 (334) 863-5540 jefferson county 1386 ROSS CLARK CIR randolph county dialysis center DOTHAN AL 36301 (334) 699-2630 dme suppliers-practice LABORATORY CORP OF AMERICA houston county MAGIC CITY DIALYSIS 1010 CHRISTINE AVE dme suppliers-practice ANNISTON AL 36207 300 22ND ST S BIRMINGHAM AL 35233 (256) 236-2818 2194 PARKWAY LAKE DR (205) 321-6178 calhoun county HOOVER AL 35244 jefferson county lab-independent (205) 560-0338 shelby county dialysis center 1102 GLENEAGLES DR SW dme suppliers-practice HUNTSVILLE AL 35801 MODEL
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