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General NPI Number Information
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NPI Number | 1992732242
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Entity Type | Organization
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Legal Business Name | RACELAND DIALYSIS CENTER
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4601 HIGHWAY 1
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City | RACELAND
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State | LA
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Zip | 70394-2624
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Country | US
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Telephone | 985-537-6962
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Fax | 985-537-6928
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Provider Business Mailing Address
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Address Line | 4424 CONLIN ST SUITE 2A
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City | METAIRIE
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State | LA
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Zip | 70006-2147
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Country | US
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Telephone | 504-780-1422
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Fax | 504-780-1432
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Authorized Official
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Title or Position | CEO
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Name | MR. MURAT HATIPOGLU
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Credential |
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Telephone | 504-780-1422
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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 | 109
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License Number State | LA
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