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General NPI Number Information
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NPI Number | 1083032098
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Entity Type | Organization
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Legal Business Name | CAPES DIALYSIS LLC
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 1700 HARRISON ST STE F
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City | BATESVILLE
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State | AR
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Zip | 72501-7315
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Country | US
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Telephone | 870-307-0828
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Fax | 870-793-5466
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Provider Business Mailing Address
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Address Line | 5200 VIRGINIA WAY L & C DEPARTMENT
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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 | 615-320-4268
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Fax | 877-238-0567
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER
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Name | JOHN WINSTEL
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Credential | CHAIRMAN
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Telephone | 253-373-3045
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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 | 04D0962206
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License Number State | AR
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