MEDICARE: HUNTINGTON ARTIFICIAL KIDNEY CENTER LTD

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

Other Identifiers

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

General Provider Information

NPI Number	:	1902834559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTINGTON ARTIFICIAL KIDNEY CENTER LTD

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	:	615-320-4414
Fax Number	:	866-865-2884

Provider Business Practice Location Address
First Line	:	17 E OLD COUNTRY RD
Second Line	:
City	:	HICKSVILLE
State	:	NY
Zip	:	11801-4270
Country	:	US
Telephone Number	:	516-364-2100
Fax Number	:	516-364-2150

Authorized Official
Title or Position	:	CHIEF ACCOUNTING OFFICER
Name	:	JAMES K HILGER
Credential	:
Telephone Number	:	615-320-4414

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	08/09/2016

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