1992750228 NPI number — DSI RENAL INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992750228 NPI number — DSI RENAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DSI RENAL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NRI AVONDALE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992750228
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
511 UNION ST
Provider Second Line Business Mailing Address:
SUITE 1800
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37219-1733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-467-0134
Provider Business Mailing Address Fax Number:
615-234-2422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13055 W MCDOWELL RD
Provider Second Line Business Practice Location Address:
SUITE F101
Provider Business Practice Location Address City Name:
AVONDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85323-6449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-935-5460
Provider Business Practice Location Address Fax Number:
623-935-5465
Provider Enumeration Date:
05/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARR
Authorized Official First Name:
GRETCHEN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
VP OF REIMBURSEMENT
Authorized Official Telephone Number:
615-467-0134

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)