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LITTLE ROCK DIALYSIS CENTERS LLC NPI 1982822631


NPI Information

NPI: 1982822631
Provider Name: LITTLE ROCK DIALYSIS CENTERS LLC

Doing Business As: JACKSONVILLE CENTRAL DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
400 T P WHITE DR
JACKSONVILLE, AR
ZIP 72076
Phone: (501) 241-1300
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LITTLE ROCK DIALYSIS CENTERS LLC is an end-stage renal disease (esrd) treatment clinic center in Jacksonville, AR. LITTLE ROCK DIALYSIS CENTERS LLC NPI is 1982822631. The provider is registered as an organization entity type.
The provider Is Doing Business As Jacksonville Central Dialysis Center.

The provider's business location address is:

400 T P WHITE DR
JACKSONVILLE, AR
ZIP 72076-287
Phone: (501) 241-1300
Fax: (501) 985-1344

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 enumeration date for this NPI number is 4/20/2007 and was last updated on 9/25/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1167213134MEDICAIDARKANSAS

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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