Covington Trace Dialysis

LBN: Isd Renal Inc
Covington Trace Dialysis is an health care organization with primary practice located at 3999 Highway 190 East Service Rd Ste A , Covington LA 70433-4914. 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. Isd Renal Inc can be contacted via phone (985) 276-1998, or through Wey, Samuel T via phone (615) 341-6641.

Contact Information

Primary practice address
3999 Highway 190 East Service Rd Ste A Covington LA 70433-4914
Phone: (985) 276-1998
Fax: (985) 276-6856
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel T
Phone: (615) 341-6641

Health care specialties

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

Profile Details

NPI number 1881192540
LBN Legal business name Isd Renal Inc
DBA Doing business as Covington Trace Dialysis
Authorized official Wey, Samuel T
Entity Organization
Organization subpart 1 No
Enumeration date Jan 29th, 2018
Last updated May 16th, 2024 - about last year

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 1881192540 NPPES
Louisiana MEDICAID 2489054

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