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MIDWEST KIDNEY CARE LLC NPI 1174556856


NPI Information

NPI: 1174556856
Provider Name: MIDWEST KIDNEY CARE, LLC

Doing Business As: MIDWEST KIDNEY CARE-KENOSHA BRANCH

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
6804 GREEN BAY RD
SUITE 108
KENOSHA, WI
ZIP 53142
Phone: (262) 697-6323
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MIDWEST KIDNEY CARE, LLC is an end-stage renal disease (esrd) treatment clinic center in Kenosha, WI. MIDWEST KIDNEY CARE, LLC NPI is 1174556856. The provider is registered as an organization entity type.
The provider Is Doing Business As Midwest Kidney Care-kenosha Branch.

The provider's business location address is:

6804 GREEN BAY RD
SUITE 108
KENOSHA, WI
ZIP 53142-452
Phone: (262) 697-6323
Fax: (262) 397-6308

The provider's authorized official is David A Kurz .
The authorized official title is V.p. Operations and has the following contact phone number (414) 762-2020.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 10/27/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1522564MEDICARE ID-TYPE UNSPECIFIEDWISCONSIN
242061600MEDICAIDWISCONSIN

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

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