AFTON NEPHROLOGY ASSOCIATES NPI 1538265335

NPI Information

NPI: 1538265335
Provider Name: AFTON NEPHROLOGY ASSOCIATES

Doing Business As: STATE FAIR DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 23D2016752

Address:
19800 WOODWARD AVE
DETROIT, MI
ZIP 48203
Phone: (313) 893-8610
Get Directions

AFTON NEPHROLOGY ASSOCIATES is an end-stage renal disease (esrd) treatment clinic center in Detroit, MI. AFTON NEPHROLOGY ASSOCIATES NPI is 1538265335. The provider is registered as an organization entity type.
The provider Is Doing Business As State Fair Dialysis Center.

The provider's business location address is:

19800 WOODWARD AVE
DETROIT, MI
ZIP 48203-102
Phone: (313) 893-8610

The provider's authorized official is Rachel Donaldson .
The authorized official title is Ceo and has the following contact phone number (313) 893-8610.

The CLIA number assigned to this NPI record is 23D2016752 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 4/20/2008.

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	4301406139	MICHIGAN	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	08999	OTHER	MICHIGAN	BCBS
2	=========	OTHER	MICHIGAN	MOLINA
3	E77775	MEDICARE UPIN	MICHIGAN
4	D9411	OTHER	MICHIGAN	BCBS
5	232578	MEDICARE ID-TYPE UNSPECIFIED	MICHIGAN
6	9367	OTHER	MICHIGAN	CAPE HEALTH PLAN
7	14040	OTHER	MICHIGAN	MCARE
8	=========	OTHER	MICHIGAN	PPOM
9	49441	OTHER	MICHIGAN	OMNICARE
10	08999	OTHER	MICHIGAN	BCN
11	=========	OTHER	MICHIGAN	GREAT LAKES
12	=========	OTHER	MICHIGAN	AETNA

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

NPI Synchronization or Removal

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