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MILLONEE DIALYSIS LLC NPI 1356897938


NPI Information

NPI: 1356897938
Provider Name: MILLONEE DIALYSIS LLC

Doing Business As: PROGRESS AVENUE DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
4390 STURBRIDGE DR
HARRISBURG, PA
ZIP 17110
Phone: (717) 545-2805
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MILLONEE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Harrisburg, PA. MILLONEE DIALYSIS LLC NPI is 1356897938. The provider is registered as an organization entity type.
The provider Is Doing Business As Progress Avenue Dialysis.

The provider's business location address is:

4390 STURBRIDGE DR
HARRISBURG, PA
ZIP 17110-668
Phone: (717) 545-2805
Fax: (717) 545-3987

The provider's authorized official is Samuel Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The enumeration date for this NPI number is 9/1/2016 and was last updated on 3/13/2024.


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
1103500274MEDICAIDPENNSYLVANIA

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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