Fredericktown Dialysis Clinic
LBN: Nra Fredericktown Missouri Llc
Fredericktown Dialysis Clinic is an health care organization with primary practice located at 105 Armory Street , Fredericktown MO 63645-1340. 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.
Nra Fredericktown Missouri Llc can be contacted via phone (573) 783-2089, or through Fawcett, Mark R. via phone (781) 699-9000.
Contact Information
Primary practice address
105 Armory Street
Fredericktown MO 63645-1340
Phone: (573) 783-2089
Fax: (573) 783-7206
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment | 261QE0700X | NOT APPLICABLE | Missouri |
Profile Details
NPI number | 1639378474 |
---|---|
LBN Legal business name | Nra Fredericktown Missouri Llc |
DBA Doing business as | Fredericktown Dialysis Clinic |
Authorized official | Fawcett, Mark R. |
Entity | Organization |
Organization subpart 1 | Yes |
Enumeration date | Jul 12th, 2007 |
Last updated | Aug 15th, 2012 - about 12 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1639378474 | NPPES |
Missouri | Other | 26D1071779 | CLIA CERT. OF WAIVER |
Missouri | MEDICAID | 504928904 | CLIA CERT. OF WAIVER |
Popular Providers
-
Fox Valley Dialysis Ltd
1300 Waterford Dr , Aurora IL 60504-5502 -
Dialysis Center Of Lincoln Inc
1110 N 10Th St , Beatrice NE 68310-2039 -
Kidney Treatment Center San Antonio Inc
803 Castroville Rd Ste 401, San Antonio TX 78237-3148 -
Tri-Cities Dialysis Llc
306 Randall Rd , Geneva IL 60134-4200 -
Diamond Dialysis Inc.
9415 S Western Ave Ste 105, Chicago IL 60620-6232 -
Dialysis Center Of Lincoln Inc
4911 N 26Th St Suite 106, Lincoln NE 68521-1151 -
Fort Smith Regional Dialysis Center Llc
2201 Brooken Hill Dr , Fort Smith AR 72908-8611 -
South Valley Regional Dialysis Center Inc
17815 Ventura Blvd Ste 100, Encino CA 91316-3600