PRODIGY DIALYSIS NPI 1902170525

NPI Information

NPI: 1902170525
Provider Name: PRODIGY DIALYSIS
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
387 THEATRE RD
CARROLLTOWN, PA
ZIP 15722
Phone: (814) 539-0798
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PRODIGY DIALYSIS is an end-stage renal disease (esrd) treatment clinic center in Carrolltown, PA. PRODIGY DIALYSIS NPI is 1902170525. The provider is registered as an organization entity type.

The provider's business location address is:

387 THEATRE RD
CARROLLTOWN, PA
ZIP 15722-805
Phone: (814) 539-0798
Fax: (814) 536-4751

The provider's authorized official is Cory Yacynych .
The authorized official title is Practice Manager and has the following contact phone number (814) 299-4676.

The enumeration date for this NPI number is 2/29/2012 and was last updated on 9/25/2012.

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	MD042825E	PENNSYLVANIA	Yes

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: 5/5/2024

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