HARRISON DIALYSIS LLC NPI 1659522076

NPI Information

NPI: 1659522076
Provider Name: HARRISON DIALYSIS LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 04D1091242

Address:
1409 GLADDEN ST
HARRISON, AR
ZIP 72601
Phone: (870) 204-6683
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HARRISON DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Harrison, AR. HARRISON DIALYSIS LLC NPI is 1659522076. The provider is registered as an organization entity type.

The provider's business location address is:

1409 GLADDEN ST
HARRISON, AR
ZIP 72601-236
Phone: (870) 204-6683
Fax: (870) 204-6686

The provider's authorized official is Julie A Williams .
The authorized official title is Administrator and has the following contact phone number (417) 334-8288.

The CLIA number assigned to this NPI record is 04D1091242 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2008 and was last updated on 6/9/2009.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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
1	1659522076	OTHER	ARKANSAS	BLUE CROSS
2	1659522076	MEDICAID	MISSOURI
3	176925134	MEDICAID	ARKANSAS
4	042584	MEDICARE PIN	ARKANSAS

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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