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NPI Code Detail

MEDICARE: COMMUNITY DIALYSIS UNITS, LLC

MEDICARE: COMMUNITY DIALYSIS UNITS, 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/Center0667DCOH

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 : 1942206230
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY DIALYSIS UNITS, LLC
Provider Business Mailing Address
First Line : 4685 FULTON DR NW
Second Line :
City : CANTON
State : OH
Zip : 44718-2379
Country : US
Telephone Number : 330-580-4001
Fax Number : 330-580-4595
Provider Business Practice Location Address
First Line : 1320 MERCY DR NW
Second Line :
City : CANTON
State : OH
Zip : 44708-2614
Country : US
Telephone Number : 330-580-4001
Fax Number : 330-580-4595
Authorized Official
Title or Position : BILLING MANAGER
Name : SEASON LEGG
Credential :
Telephone Number : 330-649-8066
Provider Enumeration Date : 06/22/2005
Last Update Date : 08/22/2020

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Directions to “COMMUNITY DIALYSIS UNITS, LLC ” Practice Location

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