MACOMB REGIONAL DIALYSIS CENTERS L.L.C. NPI 1689870594

NPI Information

NPI: 1689870594
Provider Name: MACOMB REGIONAL DIALYSIS CENTERS, L.L.C.
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: MACOMB REGIONAL DIALYSIS CENTER
CLIA Number: 23D1075551
Address: 16151 NINTEEN MILE RD
SUITE 200
CLINTON TOWNSHIP, MI
ZIP 48038
Phone: (586) 263-8350

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NPI Details

MACOMB REGIONAL DIALYSIS CENTERS, L.L.C. is an end-stage renal disease (esrd) treatment clinic center in Clinton Township, MI. MACOMB REGIONAL DIALYSIS CENTERS, L.L.C. NPI is 1689870594. The provider is registered as an organization entity type.
The provider Is Doing Business As Macomb Regional Dialysis Center.

The provider's business location address is:

16151 NINTEEN MILE RD
SUITE 200
CLINTON TOWNSHIP, MI
ZIP 48038-158
Phone: (586) 263-8350
Fax: (586) 263-8358

The provider's authorized official is David Frederick Shepherd .
The authorized official title is Vice President / Managing Agent and has the following contact phone number (248) 642-5038.

The CLIA number assigned to this NPI record is 23D1075551 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/26/2007 and was last updated on 10/15/2018.

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	D8792	OTHER	MICHIGAN	BLUE CROSS TRADITIONAL AND TRUST
2	S09456	OTHER	MICHIGAN	BLUE CROSS TRADITIONAL AND TRUST SUPPLEMENTAL

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: 11/21/2025

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