Evanston Dialysis Center

LBN: Evanston Hospital Corporation
Evanston Dialysis Center is an health care organization with primary practice located at 112 Yellow Creek Rd , Evanston WY 82930-9266. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Evanston Hospital Corporation can be contacted via phone (307) 789-3636, or through Cooper, Randy Michael via phone (615) 221-3840.

Contact Information

Primary practice address
112 Yellow Creek Rd Evanston WY 82930-9266
Phone: (307) 789-3636
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Cooper, Randy Michael
Phone: (615) 221-3840

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 06-102 Wyoming

Profile Details

NPI number 1255304051
LBN Legal business name Evanston Hospital Corporation
DBA Doing business as Evanston Dialysis Center
Authorized official Cooper, Randy Michael
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 10th, 2006
Last updated Sep 3rd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255304051 NPPES
Wyoming MEDICAID 114835407

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