ICELANDIC DIALYSIS LLC NPI 1366961138

NPI Information

  • NPI: 1366961138
  • Provider Name: ICELANDIC DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: MEDINA SQUARE DIALYSIS
  • Address: 740 N COURT ST
    MEDINA, OH
    ZIP 44256
  • Phone: (330) 721-7824

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NPI Details

ICELANDIC DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Medina, OH. ICELANDIC DIALYSIS LLC NPI is 1366961138. The provider is registered as an organization entity type.
The provider Is Doing Business As Medina Square Dialysis.

The provider's business location address is:

740 N COURT ST
MEDINA, OH
ZIP 44256-748
Phone: (330) 721-7824
Fax: (330) 721-9540

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 enumeration date for this NPI number is 9/13/2017 and was last updated on 8/21/2024.

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

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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