MAQUOKETA KIDNEY CENTER LLC NPI 1265768451

NPI Information

NPI: 1265768451
Provider Name: MAQUOKETA KIDNEY CENTER, LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
700 W GROVE ST
MAQUOKETA, IA
ZIP 52060
Phone: (563) 652-9674
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MAQUOKETA KIDNEY CENTER, LLC is an end-stage renal disease (esrd) treatment clinic center in Maquoketa, IA. MAQUOKETA KIDNEY CENTER, LLC NPI is 1265768451. The provider is registered as an organization entity type.

The provider's business location address is:

700 W GROVE ST
MAQUOKETA, IA
ZIP 52060-163
Phone: (563) 652-9674
Fax: (563) 652-9679

The provider's authorized official is Rajesh Alla .
The authorized official title is Medical Director and has the following contact phone number (309) 762-5570.

The enumeration date for this NPI number is 10/23/2009 and was last updated on 8/29/2014.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	162543	MEDICARE OSCAR/CERTIFICATION	IOWA
2	1265768451	MEDICAID	IOWA
3	62543	OTHER	IOWA	BCBS OF IA / WELLMARK

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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