BRANBUR DIALYSIS LLC (NPI# 1043873664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043873664 |
| Entity Type | Organization |
| Organization Name | BRANBUR DIALYSIS LLC |
| Practice Address |
4650 Puddledock Rd Prince George VA 23875-1235 |
| Mailing Address |
5200 Virginia Way L & C Department Brentwood TN 37027-7569 |
| Practice Telephone | 6153415875 |
| Mailing Telephone | 6153415875 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 6153415875 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Puddledock Dialysis | Doing Business As Name - Organization |
| Street Address |
4650 PUDDLEDOCK RD |
| City | PRINCE GEORGE |
| State | VA |
| Zip Code | 23875-1235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083228902 | Lr Counseling Services, LLC | Community/Behavioral Health | 5000 Owens Way, Apt. 622, Prince George, VA 23875 | 2020-09-08 |
| 1053815423 | Yolanda Larrette Hoag | Nurse Practitioner | 4600 Puddledock Rd, Prince George, VA 23875 | 2018-03-21 |
| 1932534864 | Foundation for Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4301 Montreal Ave., Prince George, VA 23875 | 2013-09-11 |
| 1073889697 | Jemina M Liverman | Nurse Practitioner | 4260 Crossing Blvd, Prince George, VA 23875 | 2012-03-28 |
| 1245412717 | Prince George County Public Schools | Local Education Agency (LEA) | 6410 Courts Drive, Prince George, VA 23875 | 2007-11-27 |
| 1952330193 | Commonwealth of Virginia State Board of Health | Public Health or Welfare | 6459 Administration Dr., Prince George, VA 23875 | 2006-07-01 |
| 1598173155 | Divine Spine Chiropractic | Chiropractor | 4205 Crossings Blvd, Prince George, VA 23875 | 2014-07-28 |
| 1669632782 | Ashif K Jethava | Internal Medicine | 4720 Puddledock Rd, Suite 100b, Prince George, VA 23875 | 2008-06-12 |
| 1033754874 | Jessica M Larche | Nurse Practitioner | 4600 Puddledock Rd, Prince George, VA 23875-1235 | 2019-11-15 |
| 1023087368 | Mubashir A Khan | Psychiatry & Neurology | 4720 Puddledock Rd, Suite 100, Prince George, VA 23875-1237 | 2006-03-17 |
| Find all providers in zip 23875 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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|---|---|---|---|---|
| 1497363253 | Fresenius Medical Care Kempsville Home, LLC | Clinic/Center | 6161 Kempsville Cir Ste B, Norfolk, VA 23502-3932 | 2020-07-17 |
| 1760004360 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 7525 Tidewater Dr Ste 37, Norfolk, VA 23505-3700 | 2020-05-18 |
| 1871113746 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 165 Market St Ste 6, Onancock, VA 23417-4233 | 2020-04-21 |
| 1447889399 | Legacy Dialysis of Virginia | Clinic/Center | 211 Gibson St Nw Ste 209, Leesburg, VA 20176-2115 | 2020-04-03 |
| 1457907917 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 570 Westgate Shopping Ctr, Bedford, VA 24523-2643 | 2019-08-12 |
| 1306492848 | Renal Treatment Centers- Mid-atlantic, Inc. | Clinic/Center | 145 Holt Garrison Pkwy Ste 340, Danville, VA 24540-5956 | 2019-08-12 |
| 1811454226 | Mohansic Dialysis, LLC | Clinic/Center | 8123 Richmond Hwy, Alexandria, VA 22309-3613 | 2019-02-22 |
| 1720552110 | Shawano Dialysis, LLC | Clinic/Center | 13859 Village Place Dr, Midlothian, VA 23114-3503 | 2019-01-18 |
| 1528533171 | Gansett Dialysis, LLC | Clinic/Center | 8605 Westwood Center Dr Ste 100, Vienna, VA 22182-2231 | 2018-10-10 |
| 1518449784 | Renal Treatment Centers - Mid-atlantic Inc | Clinic/Center | 19980 Highland Vista Dr Ste 100, Ashburn, VA 20147-4189 | 2018-09-04 |
| Find all providers with the same taxonomy | ||||
| City | PRINCE GEORGE |
| Zip Code | 23875 |
Please comment or provide details below to improve the information on BRANBUR DIALYSIS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.