MEDICARE: DIALYSIS HEALTH CLINIC 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	163WD1100X	Peritoneal Dialysis Registered Nurse

General Provider Information

NPI Number	:	1952279960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIALYSIS HEALTH CLINIC LLC

Provider Business Mailing Address
First Line	:	3445 SOUTH BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1213
Country	:	US
Telephone Number	:	614-439-0007
Fax Number	:

Provider Business Practice Location Address
First Line	:	3445 SOUTH BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1213
Country	:	US
Telephone Number	:	614-439-0007
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	AHMET HASAHN ALI
Credential	:
Telephone Number	:	614-439-0007

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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