Antelope Dialysis Center

LBN: Shadow Dialysis Llc
Antelope Dialysis Center is an health care organization with primary practice located at 6406 Tupelo Dr Ste A, Citrus Heights CA 95621-1780. 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. Shadow Dialysis Llc can be contacted via phone (916) 721-1800, or through Wey, Samuel T. via phone (615) 341-6641.

Contact Information

Primary practice address
6406 Tupelo Dr Ste A Citrus Heights CA 95621-1780
Phone: (916) 721-1800
Fax: (916) 721-4376
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 110000455 California

Profile Details

NPI number 1780836684
LBN Legal business name Shadow Dialysis Llc
DBA Doing business as Antelope Dialysis Center
Authorized official Wey, Samuel T.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 22nd, 2008
Last updated Jul 16th, 2024 - about 5 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 1780836684 NPPES
California MEDICAID 1780836684

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