RENAL LIFE LINK INC NPI 1205892122

NPI Information

NPI: 1205892122
Provider Name: RENAL LIFE LINK INC

Doing Business As: EMBASSY LAKES ARTIFICIAL KIDNEY CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
11011 SHERIDAN ST
STE 308
HOLLYWOOD, FL
ZIP 33026
Phone: (954) 430-9166
Get Directions

RENAL LIFE LINK INC is an end-stage renal disease (esrd) treatment clinic center in Hollywood, FL. RENAL LIFE LINK INC NPI is 1205892122. The provider is registered as an organization entity type.
The provider Is Doing Business As Embassy Lakes Artificial Kidney Center.

The provider's business location address is:

11011 SHERIDAN ST
STE 308
HOLLYWOOD, FL
ZIP 33026-532
Phone: (954) 430-9166
Fax: (954) 430-9329

The provider's authorized official is John D Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 10D1036096 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 1/28/2021.

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	891265300	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

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