Healthcare Provider Details

I. General information

NPI: 1285689604
Provider Name (Legal Business Name): DSI RENAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 S GILBERT RD SUITE 109
MESA AZ
85204-6073
US

IV. Provider business mailing address

511 UNION ST SUITE 1800
NASHVILLE TN
37219-1733
US

V. Phone/Fax

Practice location:
  • Phone: 480-926-1906
  • Fax: 480-926-1909
Mailing address:
  • Phone: 615-467-0134
  • Fax: 615-234-2422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. GRETCHEN K BARR
Title or Position: VP OF REIMBURSEMENT
Credential:
Phone: 615-467-0134