NORTHSIDE DIALYSIS CENTER OF WAKE FOREST UNIVERSITY NPI 1114904133

NPI Information

NORTHSIDE DIALYSIS CENTER OF WAKE FOREST UNIVERSITY is an end-stage renal disease (esrd) treatment clinic center in Winston-salem, NC. NORTHSIDE DIALYSIS CENTER OF WAKE FOREST UNIVERSITY NPI is 1114904133. The provider is registered as an organization entity type.
The provider Is Doing Business As Northside Dialysis Center.

The provider's business location address is:

500 W HANES MILL RD
WINSTON-SALEM, NC
ZIP 27105-814
Phone: (336) 744-0577
Fax: (336) 744-9021

The provider's authorized official is Terry L Hales .
The authorized official title is Assistant Treasurer and has the following contact phone number (336) 716-3003.

The CLIA number assigned to this NPI record is 34D0989608 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/30/2005 and was last updated on 8/15/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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