LIBERTY DIALYSIS - NORTH HAVEN LLC NPI 1336206408

NPI Information

NPI: 1336206408
Provider Name: LIBERTY DIALYSIS - NORTH HAVEN LLC

Doing Business As: U.S. RENAL CARE NORTH HAVEN DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
510 WASHINGTON AVE
NORTH HAVEN, CT
ZIP 06473
Phone: (203) 234-7071
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LIBERTY DIALYSIS - NORTH HAVEN LLC is an end-stage renal disease (esrd) treatment clinic center in North Haven, CT. LIBERTY DIALYSIS - NORTH HAVEN LLC NPI is 1336206408. The provider is registered as an organization entity type.
The provider Is Doing Business As U.s. Renal Care North Haven Dialysis.

The provider's business location address is:

510 WASHINGTON AVE
NORTH HAVEN, CT
ZIP 06473-313
Phone: (203) 234-7071
Fax: (203) 234-6778

The provider's authorized official is Thomas L. Weinberg .
The authorized official title is Authorized Official and has the following contact phone number (214) 736-2700.

The CLIA number assigned to this NPI record is 07D1067344 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/1/2007 and was last updated on 3/31/2016.

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			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	004271764	MEDICAID	CONNECTICUT
2	072532	MEDICARE OSCAR/CERTIFICATION	CONNECTICUT

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: 5/5/2024

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