SUGARITE DIALYSIS LLC NPI 1497048342

NPI Information

  • NPI: 1497048342
  • Provider Name: SUGARITE DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: SHELBYVILLE ROAD DIALYSIS
  • CLIA Number: 18D2028293
  • Address: 4600 SHELBYVILLE RD
    STE 310
    LOUISVILLE, KY
    ZIP 40207
  • Phone: (502) 893-4791

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NPI Details

SUGARITE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Louisville, KY. SUGARITE DIALYSIS LLC NPI is 1497048342. The provider is registered as an organization entity type.
The provider Is Doing Business As Shelbyville Road Dialysis.

The provider's business location address is:

4600 SHELBYVILLE RD
STE 310
LOUISVILLE, KY
ZIP 40207-391
Phone: (502) 893-4791
Fax: (502) 893-4793

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

The CLIA number assigned to this NPI record is 18D2028293 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2011 and was last updated on 11/2/2023.

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

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
17100201730MEDICAIDKENTUCKY

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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