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NPI Code Detail

MEDICARE: SAKDC DAVITA DIALYSIS PARTNERS LP

MEDICARE: SAKDC DAVITA DIALYSIS PARTNERS LP
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/Center008227TX

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 : 1447214119
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAKDC DAVITA DIALYSIS PARTNERS LP
Provider Business Mailing Address
First Line : 5200 VIRGINIA WAY
Second Line : L&C DEPT
City : BRENTWOOD
State : TN
Zip : 37027-7569
Country : US
Telephone Number : 615-997-4210
Fax Number : 866-935-5481
Provider Business Practice Location Address
First Line : 1123 N MAIN AVE
Second Line : SUITE 150
City : SAN ANTONIO
State : TX
Zip : 78212-4738
Country : US
Telephone Number : 210-270-7887
Fax Number : 210-270-7892
Authorized Official
Title or Position : CHIEF ACCOUNTING OFFICER
Name : JOHN WINSTEL
Credential :
Telephone Number : 253-733-4501
Provider Enumeration Date : 04/12/2006
Last Update Date : 09/15/2022

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