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DIALYSIS CLINIC INC NPI 1396255311


NPI Information

NPI: 1396255311
Provider Name: DIALYSIS CLINIC INC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 19D0894581

Address:
2020 BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT, LA
ZIP 71118
Phone: (318) 683-4475
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DIALYSIS CLINIC INC is an end-stage renal disease (esrd) treatment clinic center in Shreveport, LA. DIALYSIS CLINIC INC NPI is 1396255311. The provider is registered as an organization entity type.

The provider's business location address is:

2020 BERT KOUNS INDUSTRIAL LOOP
SHREVEPORT, LA
ZIP 71118-315
Phone: (318) 683-4475
Fax: (318) 683-4476

The provider's authorized official is Donovan Schultz .
The authorized official title is President and has the following contact phone number (615) 327-3061.

The CLIA number assigned to this NPI record is 19D0894581 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2017 and was last updated on 10/4/2023.


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

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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