GREAT LAKES DIALYSIS WEST LLC NPI 1760803951

NPI Information

NPI: 1760803951
Provider Name: GREAT LAKES DIALYSIS WEST LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
27150 W 8 MILE RD
SOUTHFIELD, MI
ZIP 48033
Phone: (248) 914-0121
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GREAT LAKES DIALYSIS WEST LLC is an end-stage renal disease (esrd) treatment clinic center in Southfield, MI. GREAT LAKES DIALYSIS WEST LLC NPI is 1760803951. The provider is registered as an organization entity type.

The provider's business location address is:

27150 W 8 MILE RD
SOUTHFIELD, MI
ZIP 48033-590
Phone: (248) 914-0121

The provider's authorized official is Boniface A Tubie .
The authorized official title is Ceo/president/medical Director and has the following contact phone number (248) 914-0121.

The enumeration date for this NPI number is 12/15/2013 and was last updated on 12/15/2013.

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

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

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