PINE BLUFF DIALYSIS INC (NPI# 1073590923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073590923 |
| Entity Type | Organization |
| Organization Name | PINE BLUFF DIALYSIS INC |
| Other Organization Name | PINE BLUFF - US RENAL CARE |
| Practice Address |
2800 W 28th Ave Pine Bluff AR 71603-4921 |
| Mailing Address |
Po Box 251549 Plano TX 75025-1500 |
| Practice Telephone | 8705347400 |
| Mailing Telephone | (870) 931-5400 |
| Mailing Fax Number | 8709315418 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MR. THOMAS L WEINBERG (CHAIRMAN) |
| Authorized Official Telephone | 2147362730 |
| Is Organization Subpart | Y |
| Parent Organization Name | US RENAL CARE INC |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS BLUE SHIELD | 12564 | 01 |
| AR | 145245734 | 05 |
| Other Name | Type Code |
|---|---|
| Pine Bluff - US Renal Care | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2302 W 28th Ave, Suite C, Pine Bluff, AR 716035081 | 8705347400 | 8705410845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720065675 | Pine Bluff Dialysis Inc | Clinic/Center | 610 Holly St, Mc Gehee, AR 71654-2109 | 2005-12-30 |
| Street Address |
2800 W 28TH AVE |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-4921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467564369 | Jefferson County Dialysis Inc | Clinic/Center | 2910 Market Street, Suite 19, Pine Bluff, AR 71601-9806 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092597 | Fort Smith Regional Dialysis Center, LLC | Clinic/Center | 256 Northridge Drive E, Van Buren, AR 72956 | 2020-08-06 |
| 1073010518 | Toltec Dialysis LLC | Clinic/Center | 2630 Donaghey Ave, Conway, AR 72032-0000 | 2018-04-11 |
| 1588102610 | Matheson Dialysis LLC | Clinic/Center | 9022 Landers Rd Ste E, North Little Rock, AR 72117-1599 | 2017-02-09 |
| 1871031211 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 115 E Peddicord St, Dermott, AR 71638-2314 | 2017-02-06 |
| 1821455494 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 505 Saint Mary St, Lake Village, AR 71653-1722 | 2016-01-27 |
| 1912399601 | Ozark Dialysis LLC | Clinic/Center | 404 Camp Rd, Pocahontas, AR 72455-1487 | 2015-03-04 |
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1386053296 | Arkansas Staff Assisted Hemodialysis,inc | Clinic/Center | 321 Terry Pond Cv, White Hall, AR 71602-8212 | 2014-08-05 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| Find all providers with the same taxonomy | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on PINE BLUFF DIALYSIS INC.
| 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.