GOLVER DIALYSIS LLC NPI 1952847675

NPI Information

NPI: 1952847675
Provider Name: GOLVER DIALYSIS LLC

Doing Business As: LEE'S HILL DIALYSIS

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
4701 SPOTSYLVANIA PKWY
STE 109
FREDERICKSBURG, VA
ZIP 22407
Phone: (540) 898-8004
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GOLVER DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Fredericksburg, VA. GOLVER DIALYSIS LLC NPI is 1952847675. The provider is registered as an organization entity type.
The provider Is Doing Business As Lee's Hill Dialysis.

The provider's business location address is:

4701 SPOTSYLVANIA PKWY
STE 109
FREDERICKSBURG, VA
ZIP 22407-435
Phone: (540) 898-8004
Fax: (540) 710-9584

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

The CLIA number assigned to this NPI record is 49D2126926 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/19/2017 and was last updated on 1/23/2024.

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	1952847675	MEDICAID	VIRGINIA

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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