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General NPI Number Information
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NPI Number | 1174568885
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Entity Type | Organization
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Legal Business Name | OHIO RIVER DIALYSIS LLC
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 7335 YANKEE RD
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45044-9168
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Country | US
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Telephone | 513-423-8098
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Fax | 513-423-8747
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Provider Business Mailing Address
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Address Line | 5200 VIRGINIA WAY STE 400 L&C
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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 | 615-320-4458
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Fax | 877-259-3316
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER
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Name | JAMES K HILGER JR.
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Credential | 2532809501
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Telephone | 253-382-1919
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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 | 0811DC
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License Number State | OH
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