SHAWANO DIALYSIS LLC NPI 1720552110

NPI Information

NPI: 1720552110
Provider Name: SHAWANO DIALYSIS, LLC

Doing Business As: JAMES RIVER HOME DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
13859 VILLAGE PLACE DR
MIDLOTHIAN, VA
ZIP 23114
Phone: (804) 378-2170
Get Directions

SHAWANO DIALYSIS, LLC is an end-stage renal disease (esrd) treatment clinic center in Midlothian, VA. SHAWANO DIALYSIS, LLC NPI is 1720552110. The provider is registered as an organization entity type.
The provider Is Doing Business As James River Home Dialysis.

The provider's business location address is:

13859 VILLAGE PLACE DR
MIDLOTHIAN, VA
ZIP 23114-503
Phone: (804) 378-2170
Fax: (804) 378-2175

The provider's authorized official is John Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 49D2162453 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2019 and was last updated on 3/28/2023.

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	1720552110	MEDICAID	VIRGINIA

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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »