MEDICARE: LIBERTY DIALYSIS - CASTLE ROCK 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

General Provider Information

NPI Number	:	1255509170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY DIALYSIS - CASTLE ROCK LLC

Provider Business Mailing Address
First Line	:	7650 SE 27TH ST
Second Line	:	SUITE 200
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-3060
Country	:	US
Telephone Number	:	206-236-5001
Fax Number	:

Provider Business Practice Location Address
First Line	:	4352 TRAIL BOSS DR
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-7512
Country	:	US
Telephone Number	:	206-236-5001
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	RYAN B PARDO
Credential	:
Telephone Number	:	206-816-6506

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	04/06/2011

Similar Medicare Providers

1861474751 — DR. DORIS ANDREA KLEINERT M.D.
Practice Location Address:

4386 TRAIL BOSS DR
CASTLE ROCK, CO
80104-7512

Practice Phone: 303-688-8666
Practice Fax: 303-688-8260

1053373415 — DR. JOHN THOMAS CAMPBELL II M.D.
Practice Location Address:

4386 TRAIL BOSS DR , SUITE A
CASTLE ROCK, CO
80104-7512

Practice Phone: 303-688-8666
Practice Fax: 303-688-8260

1689624348 — DR. DEREK SCOTT VAUGHN D.C.
Practice Location Address:

4284 TRAIL BOSS DR , SUITE 120
CASTLE ROCK, CO
80104-7512

Practice Phone: 303-688-0454
Practice Fax: 303-688-9998

1225089980 — CHRISTINE B WALDEN MD
Practice Location Address:

4318 TRAIL BOSS DR , SUITE 100
CASTLE ROCK, CO
80104-7512

Practice Phone: 303-338-4545
Practice Fax:

1801840319 — OPTIMAL HEALTH CHIROPRACTIC INC.
Practice Location Address:

4284 TRAIL BOSS DR , SUITE 120
CASTLE ROCK, CO
80104-7512

Practice Phone: 303-688-0454
Practice Fax: 303-688-9998

1467492090 — DR. DEBORAH LYNN FROMM MD
Practice Location Address:

4318 TRAIL BOSS DR , SUITE 100
CASTLE ROCK, CO
80104-7512

Practice Phone: 303-338-4545
Practice Fax:

1346271210 — ANTHONY GEORGE CERULLO PA-C
Practice Location Address:

4386 TRAIL BOSS DR
CASTLE ROCK, CO
80104-7512

Practice Phone: 303-688-8666
Practice Fax: 303-688-8260

Directions to “LIBERTY DIALYSIS - CASTLE ROCK 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.