LAKE CHARLES DIALYSIS CENTER LLC NPI 1306848205

NPI Information

NPI: 1306848205
Provider Name: LAKE CHARLES DIALYSIS CENTER LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1801 OAK PARK BLVD
LAKE CHARLES, LA
ZIP 70601
Phone: (337) 478-9585
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LAKE CHARLES DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Lake Charles, LA. LAKE CHARLES DIALYSIS CENTER LLC NPI is 1306848205. The provider is registered as an organization entity type.

The provider's business location address is:

1801 OAK PARK BLVD
LAKE CHARLES, LA
ZIP 70601
Phone: (337) 478-9585
Fax: (337) 479-0338

The provider's authorized official is Tony W Leung .
The authorized official title is Medical Director and has the following contact phone number (337) 478-9585.

The enumeration date for this NPI number is 8/11/2005 and was last updated on 8/22/2020.

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	101	LOUISIANA	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	1654205	MEDICAID	LOUISIANA

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

NPI Synchronization or Removal

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