FORESTER DIALYSIS LLC NPI 1780825133

NPI Information

  • NPI: 1780825133
  • Provider Name: FORESTER DIALYSIS LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: BURTON DIALYSIS
  • CLIA Number: 23D1097859
  • Address: 4015 DAVISON RD
    BURTON, MI
    ZIP 48509
  • Phone: (810) 715-1312

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NPI Details

FORESTER DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Burton, MI. FORESTER DIALYSIS LLC NPI is 1780825133. The provider is registered as an organization entity type.
The provider Is Doing Business As Burton Dialysis.

The provider's business location address is:

4015 DAVISON RD
BURTON, MI
ZIP 48509-401
Phone: (810) 715-1312
Fax: (810) 715-1356

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 23D1097859 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2009 and was last updated on 12/1/2023.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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
11780825133MEDICAIDMICHIGAN

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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