Wiregrass Kidney Center

LBN: Ross Clark Circle Dialysis Llc
Wiregrass Kidney Center is an health care organization with primary practice located at 1450 Ross Clark Cir Ste 200, Dothan AL 36301-4770. 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. Ross Clark Circle Dialysis Llc can be contacted via phone (334) 792-8907, or through Wey, Samuel T. via phone (615) 341-6641.

Contact Information

Primary practice address
1450 Ross Clark Cir Ste 200 Dothan AL 36301-4770
Phone: (334) 792-8907
Fax: (334) 792-8912
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 S3503 Alabama

Profile Details

NPI number 1003070285
LBN Legal business name Ross Clark Circle Dialysis Llc
DBA Doing business as Wiregrass Kidney Center
Authorized official Wey, Samuel T.
Entity Organization
Organization subpart 1 No
Enumeration date Jul 16th, 2008
Last updated Mar 6th, 2024 - about 9 months 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 1003070285 NPPES
Florida MEDICAID 008910100
Florida MEDICAID 067833571A
Florida MEDICAID 1003070285

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