SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS LLC NPI 1932353950

NPI Information

NPI: 1932353950
Provider Name: SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS, LLC

Doing Business As: BROOKWOOD DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
8910 N 43RD AVE
STE 107
GLENDALE, AZ
ZIP 85302
Phone: (623) 937-2735
Get Directions

SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS, LLC is an end-stage renal disease (esrd) treatment clinic center in Glendale, AZ. SOUTHWEST KIDNEY DAVITA DIALYSIS PARTNERS, LLC NPI is 1932353950. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookwood Dialysis Center.

The provider's business location address is:

8910 N 43RD AVE
STE 107
GLENDALE, AZ
ZIP 85302-340
Phone: (623) 937-2735
Fax: (623) 937-2758

The provider's authorized official is Samuel T Wey .
The authorized official title is Sr Director Licensure&certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 03D1094175 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/5/2008 and was last updated on 9/1/2023.

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			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	481882	MEDICAID	ARIZONA

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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