Diamond Speedway Dialysis

LBN: Total Renal Care Inc
Diamond Speedway Dialysis is an health care organization with primary practice located at 1115 N Nova Rd , Daytona Beach FL 32117-4108. 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. Total Renal Care Inc can be contacted via phone (386) 239-6877, or through Wey, Samuel T. via phone (615) 341-6641.

Contact Information

Primary practice address
1115 N Nova Rd Daytona Beach FL 32117-4108
Phone: (386) 239-6877
Fax: (386) 239-5955
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 1225691447
LBN Legal business name Total Renal Care Inc
DBA Doing business as Diamond Speedway Dialysis
Authorized official Wey, Samuel T.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 15th, 2019
Last updated Jul 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 1225691447 NPPES
Florida MEDICAID 105554100

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