MORAINE DIALYSIS LLC NPI 1134516206

NPI Information

NPI: 1134516206
Provider Name: MORAINE DIALYSIS LLC

Doing Business As: CIRCLE CITY DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1180 W 6TH ST
STE 101
CORONA, CA
ZIP 92882
Phone: (951) 808-9068
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MORAINE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Corona, CA. MORAINE DIALYSIS LLC NPI is 1134516206. The provider is registered as an organization entity type.
The provider Is Doing Business As Circle City Dialysis.

The provider's business location address is:

1180 W 6TH ST
STE 101
CORONA, CA
ZIP 92882-135
Phone: (951) 808-9068
Fax: (951) 808-9861

The provider's authorized official is John D. Winstel .
The authorized official title is Cief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 05D2105140 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/16/2015 and was last updated on 11/15/2021.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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