PHYSICIANS DIALYSIS ACQUISITIONS INC NPI 1568424455

NPI Information

  • NPI: 1568424455
  • Provider Name: PHYSICIANS DIALYSIS ACQUISITIONS INC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: PDI GRAND RAPIDS EAST
  • CLIA Number: 23D0979240
  • Address: 1230 EKHART ST NE
    GRAND RAPIDS, MI
    ZIP 49503
  • Phone: (616) 742-8930

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NPI Details

PHYSICIANS DIALYSIS ACQUISITIONS INC is an end-stage renal disease (esrd) treatment clinic center in Grand Rapids, MI. PHYSICIANS DIALYSIS ACQUISITIONS INC NPI is 1568424455. The provider is registered as an organization entity type.
The provider Is Doing Business As Pdi Grand Rapids East.

The provider's business location address is:

1230 EKHART ST NE
GRAND RAPIDS, MI
ZIP 49503-372
Phone: (616) 742-8930
Fax: (616) 742-0456

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 23D0979240 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 9/25/2023.

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
11568424455MEDICAIDMICHIGAN

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: 11/21/2025

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