FREEPORTBAY DIALYSIS LLC (NPI# 1225300056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225300056 |
Entity Type | Organization |
Organization Name | FREEPORTBAY DIALYSIS LLC |
Other Organization Name | DRIFTWOOD DIALYSIS |
Practice Address |
1808 S West Ave Freeport IL 61032-6712 |
Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
Practice Telephone | 8152320295 |
Practice Fax Number | 8152321635 |
Mailing Telephone | 6153204514 |
Mailing Fax Number | 8665949961 |
Enumeration Date | 2012-02-09 |
Last Update Date | 2019-09-04 |
Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
Authorized Official Telephone | 2537334500 |
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 |
---|---|
Driftwood Dialysis | Doing Business As Name - Organization |
Street Address |
1808 S WEST AVE |
City | FREEPORT |
State | IL |
Zip Code | 61032-6712 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013517713 | Saad Awan | Pharmacist | 2545 Illinois 26 S, Freeport, IL 61032 | 2020-10-30 |
1891354460 | Freeport Chiropractic LLC | Chiropractor | 2 W Stephenson St, Freeport, IL 61032 | 2019-06-07 |
1487168373 | Lindsey Rae Harris-baker | Speech-Language Pathologist | 1802 W Laurel St, Freeport, IL 61032 | 2017-11-30 |
1861871246 | Pearl Pavilion LLC | Skilled Nursing Facility | 910 Kiwanis Drive, Freeport, IL 61032 | 2015-05-19 |
1245584598 | Mary E Brown | Massage Therapist | 815 W. Pleasant Street, Freeport, IL 61032 | 2012-11-07 |
1700135803 | April Braband | Specialist | 421 Exchange, Freeport, IL 61032 | 2012-09-05 |
1518198662 | Quad City Prosthetic Inc | Prosthetic/Orthotic Supplier | 1013 W Loras Dr, Suite A, Freeport, IL 61032 | 2009-08-06 |
1447486501 | Gary Alan Besley | Dentist | 1450 S. West Ave., Freeport, IL 61032 | 2009-06-03 |
1023244290 | Allies In Health Sc | Chiropractor | 418 W Meadows Dr., Freeport, IL 61032 | 2009-06-02 |
1912146614 | Kayla Nicole Rodebaugh | Specialist/Technologist | 1010 Fairway Drive, Freeport, IL 61032 | 2009-02-19 |
Find all providers in zip 61032 |
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 |
---|---|---|---|---|
1003445511 | Freeport Dialysis LLC | Clinic/Center | 326 S Brazosport Blvd, Freeport, TX 77541-4540 | 2020-04-06 |
1740216159 | Huntington Artificial Kidney Center Ltd | Clinic/Center | 351 S Main St, Freeport, NY 11520-5114 | 2006-06-25 |
1568431864 | Renal Treatment Centers-illinois Inc | Clinic/Center | 1028 S Kunkle Blvd, Freeport, IL 61032-6914 | 2006-03-17 |
1306203609 | Main Street Dialysis Center LLC | Clinic/Center | 3 N Main St, Freeport, NY 11520-2218 | 2016-01-19 |
1265697643 | Davita of New York Inc | Clinic/Center | 267 W Merrick Rd, Freeport, NY 11520-3346 | 2008-07-24 |
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1558970525 | Concerto Massachusetts LLC | Clinic/Center | 4600 W Touhy Ave Ste 100, Lincolnwood, IL 60712-1606 | 2020-07-27 |
1629697917 | East Oaks Dialysis LLC | Clinic/Center | 2950 W 26th St, Chicago, IL 60623 | 2020-04-16 |
1376162735 | Hopkinton Dialysis LLC | Clinic/Center | 6001 W Ogden Ave, Cicero, IL 60804-3739 | 2020-04-15 |
1710511399 | Fresenius Medical Care of Illinois, LLC | Clinic/Center | 1946 Grand Avenue, Granite City, IL 62040-4613 | 2020-02-24 |
1861026478 | Proctor Community Hospital | Clinic/Center | 5401 N Knoxville Ave Ste 104, Peoria, IL 61614-5021 | 2020-02-24 |
1033741608 | Fresenius Medical Care New Lenox, LLC | Clinic/Center | 662 Cedar Crossings Dr, New Lenox, IL 60451-5200 | 2020-02-11 |
1730725904 | Perryton Dialysis LLC | Clinic/Center | 8604 Woodward Ave, Woodridge, IL 60517-3171 | 2019-11-22 |
1124678529 | Dialyze Direct Il LLC | Clinic/Center | 410 S Heinlein Dr, Shelbyville, IL 62565-7800 | 2019-09-17 |
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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.