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NPI Code Detail

MEDICARE: ARA-MECHANICSVILLE DIALYSIS LLC

MEDICARE: ARA-MECHANICSVILLE DIALYSIS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023021193
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARA-MECHANICSVILLE DIALYSIS LLC
Provider Business Mailing Address
First Line : 8400 N RUN MEDICAL DR STE 100
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-2319
Country : US
Telephone Number : 804-569-6083
Fax Number : 804-569-6324
Provider Business Practice Location Address
First Line : 8400 N RUN MEDICAL DR STE 100
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23116-2319
Country : US
Telephone Number : 804-569-6083
Fax Number : 804-569-6324
Authorized Official
Title or Position : CHIEF NURSING OFFICER
Name : SARA ANNE BRADY
Credential :
Telephone Number : 208-371-7878
Provider Enumeration Date : 08/13/2006
Last Update Date : 06/13/2024

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Directions to “ARA-MECHANICSVILLE DIALYSIS LLC ” Practice Location

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