MYRTLE DIALYSIS LLC NPI 1487046652

NPI Information

  • NPI: 1487046652
  • Provider Name: MYRTLE DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: HUDSON DIALYSIS
  • CLIA Number: 52D2094908
  • Address: 421 STAGELINE RD
    HUDSON, WI
    ZIP 54016
  • Phone: (715) 381-8240

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NPI Details

MYRTLE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Hudson, WI. MYRTLE DIALYSIS LLC NPI is 1487046652. The provider is registered as an organization entity type.
The provider Is Doing Business As Hudson Dialysis.

The provider's business location address is:

421 STAGELINE RD
HUDSON, WI
ZIP 54016-848
Phone: (715) 381-8240
Fax: (715) 381-8454

The provider's authorized official is Samuel T Wey .
The authorized official title is Sr Director Licensure&certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 52D2094908 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2015 and was last updated on 9/21/2023.

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 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: 3/30/2025

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