LIBERTY DIALYSIS-BADEN LLC NPI 1962444604

NPI Information

NPI: 1962444604
Provider Name: LIBERTY DIALYSIS-BADEN LLC

Doing Business As: LIBERTY DIALYSIS-BADEN, LLC

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1682 W STATE ST
BADEN, PA
ZIP 15005
Phone: (724) 869-2830
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LIBERTY DIALYSIS-BADEN LLC is an end-stage renal disease (esrd) treatment clinic center in Baden, PA. LIBERTY DIALYSIS-BADEN LLC NPI is 1962444604. The provider is registered as an organization entity type.
The provider Is Doing Business As Liberty Dialysis-baden, Llc.

The provider's business location address is:

1682 W STATE ST
BADEN, PA
ZIP 15005-207
Phone: (724) 869-2830
Fax: (724) 869-2928

The provider's authorized official is Barry L. Blanton .
The authorized official title is Vice President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 39D1061309 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/10/2006 and was last updated on 10/17/2023.

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	392721	OTHER		HIGHMARK SECURITY BLUE MC
2	1015564120001	MEDICAID	PENNSYLVANIA

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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