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DAVITA EL PASO EAST LP NPI 1841382280


NPI Information

NPI: 1841382280
Provider Name: DAVITA EL PASO EAST LP

Doing Business As: DAVITA EAST DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 45D1060559

Address:
11989 PELLICANO DR
EL PASO, TX
ZIP 79936
Phone: (915) 856-6363
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DAVITA EL PASO EAST LP is an end-stage renal disease (esrd) treatment clinic center in El Paso, TX. DAVITA EL PASO EAST LP NPI is 1841382280. The provider is registered as an organization entity type.
The provider Is Doing Business As Davita East Dialysis.

The provider's business location address is:

11989 PELLICANO DR
EL PASO, TX
ZIP 79936-287
Phone: (915) 856-6363
Fax: (915) 856-9777

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 45D1060559 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/29/2006 and was last updated on 5/18/2021.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment008408TEXASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1184149602MEDICAIDTEXAS

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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