FORT SMITH REGIONAL DIALYSIS CENTER LLC NPI 1871596916

NPI Information

NPI: 1871596916
Provider Name: FORT SMITH REGIONAL DIALYSIS CENTER LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
2201 BROOKEN HILL DR
FORT SMITH, AR
ZIP 72908
Phone: (479) 755-6700
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FORT SMITH REGIONAL DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Fort Smith, AR. FORT SMITH REGIONAL DIALYSIS CENTER LLC NPI is 1871596916. The provider is registered as an organization entity type.

The provider's business location address is:

2201 BROOKEN HILL DR
FORT SMITH, AR
ZIP 72908-611
Phone: (479) 755-6700
Fax: (479) 755-6704

The provider's authorized official is Laura Palmer .
The authorized official title is Executive Director and has the following contact phone number (479) 755-6750.

The enumeration date for this NPI number is 5/23/2005 and was last updated on 6/13/2012.

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		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	12501	OTHER	ARKANSAS	AR BLUE CROSS
2	134859734	MEDICAID	ARKANSAS
3	140066002	MEDICAID	ARKANSAS
4	100728340A	MEDICAID	OKLAHOMA
5	57742	MEDICARE ID-TYPE UNSPECIFIED	ARKANSAS	AR MEDICARE
6	042501	MEDICARE ID-TYPE UNSPECIFIED	ARKANSAS	TRAILBLAZER MEDICARE

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

NPI Synchronization or Removal

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