LDBH LLC NPI 1629372628

NPI Information

LDBH, LLC is an end-stage renal disease (esrd) treatment clinic center in Watervliet, MI. LDBH, LLC NPI is 1629372628. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Dialysis At Lakeland Watervliet.

The provider's business location address is:

400 MEDICAL PARK DR
WATERVLIET, MI
ZIP 49098-225
Phone: (269) 684-0116
Fax: (269) 684-0271

The provider's authorized official is Ryan B Pardo .
The authorized official title is Vice President and has the following contact phone number (206) 236-5001.

The CLIA number assigned to this NPI record is 23D1043626 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/5/2011 and was last updated on 8/15/2012.

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:

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