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NPI Code Detail

MEDICARE: ISD RENAL INC

MEDICARE: ISD RENAL INC
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1629024021
Entity Type Code : Organization
Provider Name (Legal Business Name) : ISD RENAL INC
Provider Business Mailing Address
First Line : 5200 VIRGINIA WAY
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-7569
Country : US
Telephone Number : 615-341-6814
Fax Number : 800-293-8405
Provider Business Practice Location Address
First Line : 703 NE HANCOCK ST
Second Line :
City : PORTLAND
State : OR
Zip : 97212-3955
Country : US
Telephone Number : 503-493-3322
Fax Number : 503-287-9434
Authorized Official
Title or Position : CHIEF ACCOUNTING OFFICER
Name : MR. JAMES K HILGER
Credential :
Telephone Number : 253-733-4500
Provider Enumeration Date : 05/26/2006
Last Update Date : 09/05/2019

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Directions to “ISD RENAL INC ” Practice Location

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