Southeastern Renal Dialysis L.C.

LBN: Southeastern Renal Dialysis L.C.
Southeastern Renal Dialysis L.C. is an health care organization with primary practice located at 1213 S Gear Ave , West Burlington IA 52655-1679. 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. Southeastern Renal Dialysis L.C. can be contacted via phone (319) 758-0691, or through Liechty, Mary via phone (319) 385-6728.

Contact Information

Primary practice address
1213 S Gear Ave West Burlington IA 52655-1679
Phone: (319) 758-0691
Fax: (319) 758-0392
Website:
Map and Directions
Authorized official contact:
Name: Liechty, Mary
Phone: (319) 385-6728

Health care specialties

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

Profile Details

NPI number 1659337541
LBN Legal business name Southeastern Renal Dialysis L.C.
DBA Doing business as
Authorized official Liechty, Mary
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 21st, 2006
Last updated Mar 16th, 2012 - about 13 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 1659337541 NPPES
Iowa MEDICAID 0625103

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