KERSHAW DIALYSIS LLC NPI 1831615855

NPI Information

KERSHAW DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Oakland, CA. KERSHAW DIALYSIS LLC NPI is 1831615855. The provider is registered as an organization entity type.
The provider Is Doing Business As Oakland Broadway Dialysis.

The provider's business location address is:

4242 BROADWAY
OAKLAND, CA
ZIP 94611-130
Phone: (510) 654-4645
Fax: (510) 547-1548

The provider's authorized official is John D Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The CLIA number assigned to this NPI record is 05D2183536 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2017 and was last updated on 6/11/2021.

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:

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