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MY KIDNEY CENTER LLC NPI 1770823668


NPI Information

NPI: 1770823668
Provider Name: MY KIDNEY CENTER, LLC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

CLIA Number: 17D2053370

Address:
1133 COLLEGE AVE
BUILDING B, SUITE 100
MANHATTAN, KS
ZIP 66502
Phone: (785) 565-9500
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MY KIDNEY CENTER, LLC is a medical specialty clinic center in Manhattan, KS. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). MY KIDNEY CENTER, LLC NPI is 1770823668. The provider is registered as an organization entity type.

The provider's business location address is:

1133 COLLEGE AVE
BUILDING B, SUITE 100
MANHATTAN, KS
ZIP 66502-770
Phone: (785) 565-9500
Fax: (785) 565-9595

The provider's authorized official is Fadi V Bedros .
The authorized official title is Owner and has the following contact phone number (785) 565-9500.

The CLIA number assigned to this NPI record is 17D2053370 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2013 and was last updated on 8/30/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyKANSASYes

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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