ISD RENAL INC NPI 1174578595

NPI Information

NPI: 1174578595
Provider Name: ISD RENAL INC

Doing Business As: OSCEOLA DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 04D2075414

Address:
1332 W KEISER AVE
OSCEOLA, AR
ZIP 72370
Phone: (870) 563-4901
Get Directions

ISD RENAL INC is an end-stage renal disease (esrd) treatment clinic center in Osceola, AR. ISD RENAL INC NPI is 1174578595. The provider is registered as an organization entity type.
The provider Is Doing Business As Osceola Dialysis.

The provider's business location address is:

1332 W KEISER AVE
OSCEOLA, AR
ZIP 72370-919
Phone: (870) 563-4901
Fax: (870) 563-4959

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 04D2075414 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 4/9/2024.

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	161527134	MEDICAID	ARKANSAS

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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