1033511092 NPI number — INFINITI DIALYSIS CENTER OF CINCINNATI LLC.

Table of content: (NPI 1033511092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033511092 NPI number — INFINITI DIALYSIS CENTER OF CINCINNATI LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INFINITI DIALYSIS CENTER OF CINCINNATI LLC.
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:
Provider Other Organization Name Type Code:
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:
1033511092
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4665 E GALBRAITH RD STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45236-2783
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-791-2137
Provider Business Mailing Address Fax Number:
513-791-2151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4665 E GALBRAITH RD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45236-2783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-791-2152
Provider Business Practice Location Address Fax Number:
513-791-2151
Provider Enumeration Date:
09/22/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TINDNI
Authorized Official First Name:
ARSHDEEP
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
419-604-2967

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QE0700X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0144759 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1120DC . This is a "FACILITY ID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".