CALAVERAS DIALYSIS LLC NPI 1295070761

NPI Information

NPI: 1295070761
Provider Name: CALAVERAS DIALYSIS LLC

Doing Business As: PAPAGO DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
5115 E THOMAS RD
STE 115
PHOENIX, AZ
ZIP 85018
Phone: (602) 840-4124
Get Directions

CALAVERAS DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Phoenix, AZ. CALAVERAS DIALYSIS LLC NPI is 1295070761. The provider is registered as an organization entity type.
The provider Is Doing Business As Papago Dialysis Center.

The provider's business location address is:

5115 E THOMAS RD
STE 115
PHOENIX, AZ
ZIP 85018-914
Phone: (602) 840-4124
Fax: (602) 840-3362

The provider's authorized official is James K Hilger .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4500.

The CLIA number assigned to this NPI record is 03D0936361 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/10/2012 and was last updated on 10/1/2013.

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	OTC 0725	ARIZONA	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	032553	MEDICARE OSCAR/CERTIFICATION	ARIZONA
2	181876	MEDICAID	ARIZONA

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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