MEDICARE: SOUTHEASTERN INDIANA DIALYSIS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043475312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHEASTERN INDIANA DIALYSIS LLC

Provider Business Mailing Address
First Line	:	5200 VIRGINIA WAY
Second Line	:	STE 400 L&C
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7569
Country	:	US
Telephone Number	:	615-320-4521
Fax Number	:	866-594-2894

Provider Business Practice Location Address
First Line	:	2340 NORTH STATE HIGHWAY 7
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-7183
Country	:	US
Telephone Number	:	812-352-8150
Fax Number	:	812-352-8204

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JIM HILGER
Credential	:
Telephone Number	:	253-382-1919

Provider Enumeration Date	:	07/25/2008
Last Update Date	:	10/16/2009

Similar Medicare Providers

1861333908 — NORTH STAR MEDICARE LLC
Practice Location Address:

195 S HIGHWAY 89
NORTH SALT LAKE, UT
84054-2543

Practice Phone: 307-289-2158
Practice Fax:

1639492200 — TOTAL RENAL CARE INC
Practice Location Address:

2340 N STATE HIGHWAY 7
NORTH VERNON, IN
47265-7183

Practice Phone: 812-352-8150
Practice Fax: 812-352-8204

1194469791 — MRS. CHARLENE BROSIUS REGISTERED NURSE
Practice Location Address:

7183 SCHULTZ RD
NORTH TONAWANDA, NY
14120-9646

Practice Phone: 716-512-8474
Practice Fax:

1548153349 — MOBILE LABS PRO
Practice Location Address:

7183 KENSSINGTON DRIVE
NORTH RIDGEVILLE, OH
44039

Practice Phone: 440-328-8125
Practice Fax: 440-709-1615

1346435229 — PATRICIA ANN FIELDS PMHNP APRN
Practice Location Address:

301 HENRY ST
NORTH VERNON, IN
47265-1030

Practice Phone: 812-883-6779
Practice Fax: 812-352-2420

1922947605 — SARAH SHEPHERD
Practice Location Address:

1405 W COUNTY ROAD 800 N
NORTH VERNON, IN
47265-5210

Practice Phone: 812-592-7605
Practice Fax:

Directions to “SOUTHEASTERN INDIANA DIALYSIS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.