HILLIARD DIALYSIS CENTER LLC NPI 1134144959

NPI Information

NPI: 1134144959
Provider Name: HILLIARD DIALYSIS CENTER LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 10D1050084

Address:
551858 US HIGHWAY 1
SUITE 118
HILLIARD, FL
ZIP 32046
Phone: (904) 845-2612
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HILLIARD DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Hilliard, FL. HILLIARD DIALYSIS CENTER LLC NPI is 1134144959. The provider is registered as an organization entity type.

The provider's business location address is:

551858 US HIGHWAY 1
SUITE 118
HILLIARD, FL
ZIP 32046-822
Phone: (904) 845-2612
Fax: (904) 845-2614

The provider's authorized official is Sara Anne Brady .
The authorized official title is Chief Nursing Officer and has the following contact phone number (208) 371-7878.

The CLIA number assigned to this NPI record is 10D1050084 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2006 and was last updated on 1/14/2023.

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

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	891398600	MEDICAID	FLORIDA

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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