LIBERTY DIALYSIS - IDAHO FALLS LLC NPI 1487692950

NPI Information

NPI: 1487692950
Provider Name: LIBERTY DIALYSIS - IDAHO FALLS LLC

Doing Business As: LIBERTY DIALYSIS-IDAHO FALLS LLC

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
2381 E SUNNYSIDE RD
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 523-8500
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LIBERTY DIALYSIS - IDAHO FALLS LLC is an end-stage renal disease (esrd) treatment clinic center in Idaho Falls, ID. LIBERTY DIALYSIS - IDAHO FALLS LLC NPI is 1487692950. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Dialysis-idaho Falls Llc.

The provider's business location address is:

2381 E SUNNYSIDE RD
IDAHO FALLS, ID
ZIP 83404-521
Phone: (208) 523-8500
Fax: (208) 523-8502

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 10/17/2023.

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

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: 5/5/2024

NPI Synchronization or Removal

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