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ELKIN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY NPI 1477530525


NPI Information

NPI: 1477530525
Provider Name: ELKIN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY

Doing Business As: ELKIN DIALYSIS CENTER

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 34D0992899

Address:
941 JOHNSON RIDGE RD
ELKIN, NC
ZIP 28621
Phone: (336) 527-4722
Get Directions

ELKIN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY is an end-stage renal disease (esrd) treatment clinic center in Elkin, NC. ELKIN DIALYSIS CENTER OF WAKE FOREST UNIVERSITY NPI is 1477530525. The provider is registered as an organization entity type.
The provider Is Doing Business As Elkin Dialysis Center.

The provider's business location address is:

941 JOHNSON RIDGE RD
ELKIN, NC
ZIP 28621-211
Phone: (336) 527-4722
Fax: (336) 527-4610

The provider's authorized official is Terry L Hales .
The authorized official title is Assistant Treasurer and has the following contact phone number (336) 716-3003.

The CLIA number assigned to this NPI record is 34D0992899 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/29/2005 and was last updated on 8/15/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentNORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13402614MEDICAIDNORTH CAROLINA
20001AAOTHERNORTH CAROLINABCBS-NC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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