WISCONSIN DIALYSIS INC. NPI 1114035912

NPI Information

NPI: 1114035912
Provider Name: WISCONSIN DIALYSIS, INC.

Other Name: EAST CLINIC

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
4600 AMERICAN PKWY
STE 108
MADISON, WI
ZIP 53718
Phone: (608) 243-3003
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WISCONSIN DIALYSIS, INC. is an end-stage renal disease (esrd) treatment clinic center in Madison, WI. WISCONSIN DIALYSIS, INC. NPI is 1114035912. The provider is registered as an organization entity type.
The provider Other Name Is East Clinic.

The provider's business location address is:

4600 AMERICAN PKWY
STE 108
MADISON, WI
ZIP 53718-337
Phone: (608) 243-3003
Fax: (608) 243-3005

The provider's authorized official is Kristine Holmes .
The authorized official title is Authorized Official and has the following contact phone number (608) 270-5624.

The enumeration date for this NPI number is 8/29/2006 and was last updated on 6/24/2019.

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	42059900	MEDICAID	WISCONSIN

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: 4/28/2024

NPI Synchronization or Removal

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