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REFUGE DIALYSIS LLC NPI 1194048702


NPI Information

NPI: 1194048702
Provider Name: REFUGE DIALYSIS LLC

Doing Business As: EVERETT DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 50D2006314

Address:
8130 EVERGREEN WAY
EVERETT, WA
ZIP 98203
Phone: (425) 353-6036
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REFUGE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Everett, WA. REFUGE DIALYSIS LLC NPI is 1194048702. The provider is registered as an organization entity type.
The provider Is Doing Business As Everett Dialysis Center.

The provider's business location address is:

8130 EVERGREEN WAY
EVERETT, WA
ZIP 98203-419
Phone: (425) 353-6036
Fax: (425) 353-1210

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 50D2006314 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/10/2010 and was last updated on 12/21/2023.


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 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
11194048702MEDICAIDWASHINGTON

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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