RENAL LIFE LINK INC NPI 1306808472

NPI Information

  • NPI: 1306808472
  • Provider Name: RENAL LIFE LINK INC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: DUNMORE DIALYSIS
  • CLIA Number: 39D1047808
  • Address: 1212 ONEILL HWY
    DUNMORE, PA
    ZIP 18512
  • Phone: (570) 558-0190

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NPI Details

RENAL LIFE LINK INC is an end-stage renal disease (esrd) treatment clinic center in Dunmore, PA. RENAL LIFE LINK INC NPI is 1306808472. The provider is registered as an organization entity type.
The provider Is Doing Business As Dunmore Dialysis.

The provider's business location address is:

1212 ONEILL HWY
DUNMORE, PA
ZIP 18512-717
Phone: (570) 558-0190
Fax: (570) 558-0195

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 39D1047808 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/4/2006 and was last updated on 11/15/2024.

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
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11014890420004MEDICAIDPENNSYLVANIA

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: 11/21/2025

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