MASSENA CENTER LLC NPI 1770989295

NPI Information

NPI: 1770989295
Provider Name: MASSENA CENTER LLC

Doing Business As: MASSENA DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 33D2089859

Address:
290 MAIN ST
MASSENA, NY
ZIP 13662
Phone: (315) 705-0101
Get Directions

MASSENA CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Massena, NY. MASSENA CENTER LLC NPI is 1770989295. The provider is registered as an organization entity type.
The provider Is Doing Business As Massena Dialysis Center.

The provider's business location address is:

290 MAIN ST
MASSENA, NY
ZIP 13662-901
Phone: (315) 705-0101
Fax: (315) 705-0403

The provider's authorized official is Sara Anne Brady .
The authorized official title is Chief Nursing Officer and has the following contact phone number (208) 371-7878.

The CLIA number assigned to this NPI record is 33D2089859 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/11/2014 and was last updated on 1/14/2023.

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	04087734	MEDICAID	NEW YORK

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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