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ISD RENAL INC. NPI 1376077123


NPI Information

NPI: 1376077123
Provider Name: ISD RENAL, INC.

Doing Business As: CROSS KEYS DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
14001 NEW HALLS FERRY RD STE 133
FLORISSANT, MO
ZIP 63033
Phone: (314) 839-7416
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ISD RENAL, INC. is an end-stage renal disease (esrd) treatment clinic center in Florissant, MO. ISD RENAL, INC. NPI is 1376077123. The provider is registered as an organization entity type.
The provider Is Doing Business As Cross Keys Dialysis.

The provider's business location address is:

14001 NEW HALLS FERRY RD STE 133
FLORISSANT, MO
ZIP 63033-708
Phone: (314) 839-7416
Fax: (314) 839-7464

The provider's authorized official is John Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The enumeration date for this NPI number is 4/19/2017 and was last updated on 6/9/2020.


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 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
1137607712MEDICAIDMISSOURI

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: 11/14/2023

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