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PHYSICIANS DIALYSIS ACQUISITIONS INC NPI 1346374436


NPI Information

NPI: 1346374436
Provider Name: PHYSICIANS DIALYSIS ACQUISITIONS INC

Doing Business As: PDI WORCESTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 22D1033198

Address:
19 GLENNIE ST
STE A
WORCESTER, MA
ZIP 01605
Phone: (508) 421-9539
Get Directions

PHYSICIANS DIALYSIS ACQUISITIONS INC is an end-stage renal disease (esrd) treatment clinic center in Worcester, MA. PHYSICIANS DIALYSIS ACQUISITIONS INC NPI is 1346374436. The provider is registered as an organization entity type.
The provider Is Doing Business As Pdi Worcester.

The provider's business location address is:

19 GLENNIE ST
STE A
WORCESTER, MA
ZIP 01605-918
Phone: (508) 421-9539
Fax: (508) 421-6653

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 22D1033198 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 2/19/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11322168MEDICAIDMASSACHUSETTS

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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