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DIALYSIS ACCESS CENTER LLC NPI 1578879847


NPI Information

NPI: 1578879847
Provider Name: DIALYSIS ACCESS CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
400 JOHN DEERE RD
BUILDING 2
MOLINE, IL
ZIP 61265
Phone: (309) 797-0594
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DIALYSIS ACCESS CENTER, LLC is an ambulatory surgical clinic center in Moline, IL. DIALYSIS ACCESS CENTER, LLC NPI is 1578879847. The provider is registered as an organization entity type.

The provider's business location address is:

400 JOHN DEERE RD
BUILDING 2
MOLINE, IL
ZIP 61265-898
Phone: (309) 797-0594
Fax: (309) 762-5297

The provider's authorized official is Rajesh Alla .
The authorized official title is Medical Director and has the following contact phone number (309) 762-5570.

The enumeration date for this NPI number is 8/25/2010 and was last updated on 8/29/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1IL5611OTHERILLINOISMEDICARE PTAN
251756OTHERILLINOISBLUE CROSS BLUE SHIELD OF ILLINOIS
314C0001147MEDICARE OSCAR/CERTIFICATIONILLINOIS
4=========001MEDICAIDILLINOIS

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: 4/28/2024

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