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General NPI Number Information
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NPI Number | 1457810269
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Entity Type | Organization
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Legal Business Name | ONE DIALYSIS NETWORK
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 300 25TH ST APT 312
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-3496
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Country | US
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Telephone | 314-315-1732
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Fax |
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Provider Business Mailing Address
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Address Line | 300 25TH ST APT 312
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-3496
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Country | US
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Telephone | 314-315-1732
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KELSIE MCKINNEY
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Credential |
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Telephone | 314-315-1732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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