JASPER-ARA DIALYSIS L.L.P. NPI 1679684567

NPI Information

NPI: 1679684567
Provider Name: JASPER-ARA DIALYSIS L.L.P.

Doing Business As: KIDNEY CENTER OF JASPER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
930 MARVIN HANCOCK DR
JASPER, TX
ZIP 75951
Phone: (409) 384-4200
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JASPER-ARA DIALYSIS L.L.P. is an end-stage renal disease (esrd) treatment clinic center in Jasper, TX. JASPER-ARA DIALYSIS L.L.P. NPI is 1679684567. The provider is registered as an organization entity type.
The provider Is Doing Business As Kidney Center Of Jasper.

The provider's business location address is:

930 MARVIN HANCOCK DR
JASPER, TX
ZIP 75951-752
Phone: (409) 384-4200
Fax: (409) 384-4255

The provider's authorized official is Sara Anne Brady .
The authorized official title is Chief Nursing Officer and has the following contact phone number (208) 371-7878.

The CLIA number assigned to this NPI record is 45D0986844 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 1/10/2023.

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

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
1	145502402	MEDICAID	TEXAS

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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