FORREST CITY DIALYSIS NPI 1811315823

NPI Information

NPI: 1811315823
Provider Name: FORREST CITY DIALYSIS

Other Name: RENAL TREATMENT CTRS SOUTHEAST LP

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
5200 VIRGINIA WAY
L & C DEPARTMENT
BRENTWOOD, TN
ZIP 37027
Phone: (615) 320-4236
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FORREST CITY DIALYSIS is an end-stage renal disease (esrd) treatment clinic center in Brentwood, TN. FORREST CITY DIALYSIS NPI is 1811315823. The provider is registered as an organization entity type.
The provider Other Name Is Renal Treatment Ctrs Southeast Lp.

The provider's business location address is:

5200 VIRGINIA WAY
L & C DEPARTMENT
BRENTWOOD, TN
ZIP 37027
Phone: (615) 320-4236

The provider's authorized official is James Hilger .
The authorized official title is Cao and has the following contact phone number (303) 876-6000.

The enumeration date for this NPI number is 4/7/2014 and was last updated on 6/15/2018.

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	1457673345	ARKANSAS	No
2	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	04D1096838	ARKANSAS	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	180379134	MEDICAID	ARKANSAS

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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