WEST ORANGE PALM COAST DIALYSIS CENTER LLC NPI 1972074086

NPI Information

NPI: 1972074086
Provider Name: WEST ORANGE PALM COAST DIALYSIS CENTER LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 10D2103613

Address:
57 TOWN CT STE 118
PALM COAST, FL
ZIP 32164
Phone: (407) 297-8408
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WEST ORANGE PALM COAST DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Palm Coast, FL. WEST ORANGE PALM COAST DIALYSIS CENTER LLC NPI is 1972074086. The provider is registered as an organization entity type.

The provider's business location address is:

57 TOWN CT STE 118
PALM COAST, FL
ZIP 32164-425
Phone: (407) 297-8408

The provider's authorized official is Akin Awosika .
The authorized official title is Cfo and has the following contact phone number (407) 927-5873.

The CLIA number assigned to this NPI record is 10D2103613 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2018 and was last updated on 12/16/2018.

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

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