HOME DIALYSIS OF SANTA FE LLC NPI 1124477112

NPI Information

NPI: 1124477112
Provider Name: HOME DIALYSIS OF SANTA FE, LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 32D2125018

Address:
2904 RODEO PARK DR E STE 300A-1
SANTA FE, NM
ZIP 87505
Phone: (505) 467-8199
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HOME DIALYSIS OF SANTA FE, LLC is an end-stage renal disease (esrd) treatment clinic center in Santa Fe, NM. HOME DIALYSIS OF SANTA FE, LLC NPI is 1124477112. The provider is registered as an organization entity type.

The provider's business location address is:

2904 RODEO PARK DR E STE 300A-1
SANTA FE, NM
ZIP 87505-305
Phone: (505) 467-8199
Fax: (505) 467-8519

The provider's authorized official is Biju Cherian .
The authorized official title is Managing Member and has the following contact phone number (505) 264-8120.

The CLIA number assigned to this NPI record is 32D2125018 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2016 and was last updated on 1/13/2023.

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:

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: 4/28/2024

NPI Synchronization or Removal

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