GREENLEAF DIALYSIS LLC NPI 1447500343

NPI Information

NPI: 1447500343
Provider Name: GREENLEAF DIALYSIS LLC

Doing Business As: GAINESVILLE HOME DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 10D2048858

Address:
4960 W NEWBERRY RD
STE 280
GAINESVILLE, FL
ZIP 32607
Phone: (352) 378-4960
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GREENLEAF DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Gainesville, FL. GREENLEAF DIALYSIS LLC NPI is 1447500343. The provider is registered as an organization entity type.
The provider Is Doing Business As Gainesville Home Dialysis.

The provider's business location address is:

4960 W NEWBERRY RD
STE 280
GAINESVILLE, FL
ZIP 32607-201
Phone: (352) 378-4960
Fax: (352) 371-1552

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

The CLIA number assigned to this NPI record is 10D2048858 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/18/2012 and was last updated on 1/10/2022.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100167000	MEDICAID	FLORIDA

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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