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LIBERTY DIALYSIS - HAWAII LLC NPI 1235171588


NPI Information

NPI: 1235171588
Provider Name: LIBERTY DIALYSIS - HAWAII LLC

Doing Business As: LIBERTY DIALYSIS HAWAII - KAUAI DIALYSIS FACILITY

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 12D1051941

Address:
3224 ELUA ST
LIHUE, HI
ZIP 96766
Phone: (808) 245-3770
Get Directions

LIBERTY DIALYSIS - HAWAII LLC is an end-stage renal disease (esrd) treatment clinic center in Lihue, HI. LIBERTY DIALYSIS - HAWAII LLC NPI is 1235171588. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Dialysis Hawaii - Kauai Dialysis Facility.

The provider's business location address is:

3224 ELUA ST
LIHUE, HI
ZIP 96766-213
Phone: (808) 245-3770
Fax: (808) 245-2390

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 12D1051941 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 8/11/2021.


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 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
100B0257465OTHERHAWAIIHMSA

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: 11/14/2023

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