MARYSVILLE DIALYSIS CENTER LLC NPI 1487617817

NPI Information

  • NPI: 1487617817
  • Provider Name: MARYSVILLE DIALYSIS CENTER LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: MARYSVILLE DIALYSIS CENTER
  • CLIA Number: 05D1077522
  • Address: 1015 8TH ST
    MARYSVILLE, CA
    ZIP 95901
  • Phone: (530) 741-9801

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NPI Details

MARYSVILLE DIALYSIS CENTER LLC is an end-stage renal disease (esrd) treatment clinic center in Marysville, CA. MARYSVILLE DIALYSIS CENTER LLC NPI is 1487617817. The provider is registered as an organization entity type.
The provider Is Doing Business As Marysville Dialysis Center.

The provider's business location address is:

1015 8TH ST
MARYSVILLE, CA
ZIP 95901-271
Phone: (530) 741-9801
Fax: (530) 741-9805

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp, Licensure & Certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 05D1077522 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/7/2006 and was last updated on 11/27/2023.

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) Treatment110000524CALIFORNIAYes

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
11487617817MEDICAIDCALIFORNIA

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: 3/30/2025

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