BOISE DIALYSIS LLC NPI 1639115785

NPI Information

BOISE DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Meridian, ID. BOISE DIALYSIS LLC NPI is 1639115785. The provider is registered as an organization entity type.
The provider Is Doing Business As Boise Dialysis, Llc.

The provider's business location address is:

3525 E LOUISE DR
MERIDIAN, ID
ZIP 83642-303
Phone: (208) 846-9815
Fax: (208) 884-2032

The provider's authorized official is Barry L. Blanton .
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 13D1038652 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2006 and was last updated on 8/23/2021.

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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