SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC NPI 1306237656

NPI Information

SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS, LLC is an end-stage renal disease (esrd) treatment clinic center in Phoenix, AZ. SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS, LLC NPI is 1306237656. The provider is registered as an organization entity type.
The provider Is Doing Business As Phoenix Home Dialysis.

The provider's business location address is:

5115 E THOMAS RD
STE 100
PHOENIX, AZ
ZIP 85018-914
Phone: (602) 840-0072
Fax: (602) 956-1405

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

The CLIA number assigned to this NPI record is 03D2095117 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/9/2015 and was last updated on 10/10/2023.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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