JEFFERSON CITY RENAL SERVICES LLC NPI 1568975886

NPI Information

NPI: 1568975886
Provider Name: JEFFERSON CITY RENAL SERVICES LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 26D0672729

Address:
1241 W STADIUM BLVD # LL1
JEFFERSON CITY, MO
ZIP 65109
Phone: (573) 632-2633
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JEFFERSON CITY RENAL SERVICES LLC is an end-stage renal disease (esrd) treatment clinic center in Jefferson City, MO. JEFFERSON CITY RENAL SERVICES LLC NPI is 1568975886. The provider is registered as an organization entity type.

The provider's business location address is:

1241 W STADIUM BLVD # LL1
JEFFERSON CITY, MO
ZIP 65109-023
Phone: (573) 632-2633
Fax: (573) 632-4393

The provider's authorized official is Donovan Schultz .
The authorized official title is President Of Member and has the following contact phone number (615) 327-3061.

The CLIA number assigned to this NPI record is 26D0672729 - prison with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 11/8/2017 and was last updated on 4/3/2024.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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

NPI Synchronization or Removal

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