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NPI 1043752769

NPI 1043752769 : TRUE NORTH DIALYSIS CENTER LLC : GREAT NECK, NY

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General NPI Number Information
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    NPI Number           |    1043752769
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    Entity Type          |    Organization 
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    Legal Business Name  |    TRUE NORTH DIALYSIS CENTER LLC 
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Dates
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    Enumeration Date     |    11/11/2016
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    Last Update Date     |    04/20/2023
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Provider Practice Location Address
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    Address Line         |    100 COMMUNITY DR 
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    City                 |    GREAT NECK
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    State                |    NY
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    Zip                  |    11021-5501
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    Country              |    US
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    Telephone            |    516-487-3058
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    Fax                  |    516-487-4918
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Provider Business Mailing Address
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    Address Line         |    5200 VIRGINIA WAY ATT: L&C DEPT
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    City                 |    BRENTWOOD
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    State                |    TN
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    Zip                  |    37027-7569
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    Country              |    US
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    Telephone            |    615-341-6410
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    Fax                  |    888-662-8259
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Authorized Official
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    Title or Position    |    CHIEF ACCOUNTING OFFICER
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    Name                 |     JOHN D WINSTEL 
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    Credential           |    
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    Telephone            |    253-733-4501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QE0700X
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    Taxonomy Name        |    End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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    License Number       |    
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    License Number State |    
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