FANTHORP DIALYSIS LLC NPI 1538414941

NPI Information

FANTHORP DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Mankato, MN. FANTHORP DIALYSIS LLC NPI is 1538414941. The provider is registered as an organization entity type.
The provider Is Doing Business As Dialysis At Mankato Clinic.

The provider's business location address is:

1400 MADISON AVE STE 400
MANKATO, MN
ZIP 56001-476
Phone: (507) 385-0432
Fax: (507) 385-1584

The provider's authorized official is John 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 24D2048442 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/23/2012 and was last updated on 10/20/2020.

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:

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.