NPI: 1609044569
Provider Name: LIBERTY DIALYSIS-NORTHWEST RENO LLC
Doing Business As: LIBERTY DIALYSIS-NORTHWEST RENO, LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization
Specialization: End-Stage Renal Disease (ESRD) Treatment
CLIA Number: 29D1093489
Address:
6144 MAE ANNE AVE
RENO, NV
ZIP 89523
Phone: (775) 747-1100
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LIBERTY DIALYSIS-NORTHWEST RENO LLC is an end-stage renal disease (esrd) treatment clinic center in Reno, NV. LIBERTY DIALYSIS-NORTHWEST RENO LLC NPI is 1609044569. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Dialysis-northwest Reno, Llc.
The provider's business location address is:
6144 MAE ANNE AVE
RENO, NV
ZIP 89523-721
Phone: (775) 747-1100
Fax: (775) 747-1115
The provider's authorized official is Mark Fawcett .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.
The CLIA number assigned to this NPI record is 29D1093489 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/13/2008 and was last updated on 1/23/2024.