1760438329 NPI number — DSI RENAL INC

Table of content: (NPI 1760438329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760438329 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 PROVIDENCE
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:
1760438329
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2008
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:
615-234-1165
Provider Business Mailing Address Fax Number:
615-234-2494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 HEMINGWAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02915-2224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-438-5930
Provider Business Practice Location Address Fax Number:
401-438-5090
Provider Enumeration Date:
05/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FEATHERSTON
Authorized Official First Name:
TYRONDA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING SPECIALIST
Authorized Official Telephone Number:
615-234-1165

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)