Fayetteville Dialysis

LBN: Fayetteville Dialysis
Fayetteville Dialysis is an health care organization with primary practice located at 1423 Pacific Ave , Tacoma WA 98402-4203. 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. Fayetteville Dialysis can be contacted via phone (253) 382-1752, or through Thiry, Kent via phone (303) 876-6000.

Contact Information

Primary practice address
1423 Pacific Ave Tacoma WA 98402-4203
Phone: (253) 382-1752
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Thiry, Kent CHAIRMAN
Phone: (303) 876-6000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 04D0922946 Arkansas
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 1295913416 Arkansas

Profile Details

NPI number 1811315971
LBN Legal business name Fayetteville Dialysis
DBA Doing business as
Authorized official Thiry, Kent CHAIRMAN
Entity Organization
Organization subpart 1 No
Enumeration date Apr 4th, 2014
Last updated Apr 4th, 2014 - about 11 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 1811315971 NPPES
Arkansas MEDICAID 168261134

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