LAKESHORE DIALYSIS LLC (NPI# 1427399369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427399369 |
Entity Type | Organization |
Organization Name | LAKESHORE DIALYSIS LLC |
Other Organization Name | FIVE RIVERS DIALYSIS |
Practice Address |
4750 N Main St Dayton OH 45405-5021 |
Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
Practice Telephone | 9372785139 |
Practice Fax Number | 9372785722 |
Mailing Telephone | 6152383051 |
Mailing Fax Number | 8002468346 |
Enumeration Date | 2013-03-01 |
Last Update Date | 2020-06-25 |
Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
Authorized Official Telephone | 2537334501 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0099627 | 05 |
Other Name | Type Code |
---|---|
Five Rivers Dialysis | Doing Business As Name - Organization |
Street Address |
4750 N MAIN ST |
City | DAYTON |
State | OH |
Zip Code | 45405-5021 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497252613 | Christina Giuffrida | Student in an Organized Health Care Education/Training Program | Grandview Medical Center, Ou Medical Education Office, 405 W. Grand Avenue, Dayton, OH 45405 | 2018-04-13 |
1740718410 | Iain William Decker | Student in an Organized Health Care Education/Training Program | 330 Forest Ave, Dayton, OH 45405 | 2017-05-25 |
1144779000 | Horizon Home Healthcare Service, LLC | Home Health | 201 Riverside Dr Ste 2h, Dayton, OH 45405 | 2016-10-03 |
1629347695 | Grandview Hospital | General Acute Care Hospital | 405 West Grand Avenue, Dayton, OH 45405 | 2011-12-21 |
1962712265 | Lakisha L Barber | Licensed Practical Nurse | 2039 Rustic Road, Dayton, OH 45405 | 2010-10-20 |
1457685232 | Sally Ann Easton | Occupational Therapy Assistant | 1390 King Tree Drive, Dayton, OH 45405 | 2009-09-25 |
1083848535 | Azeem Z. Vasi | Otolaryngology | 405 W. Grand Ave., Grandview Hospital and Medical Center- Medical Educatio, Dayton, OH 45405 | 2009-05-13 |
1588823306 | Dorothy W Clarke | Dietitian, Registered | 405 W Grand, Dayton, OH 45405 | 2008-06-06 |
1831243062 | Brian Michael Glenn | Nurse Anesthetist, Certified Registered | 450 W. Grand Avenue, Dayton, OH 45405 | 2007-01-23 |
1003989807 | Han Mok Yang | Internal Medicine | 3213 North Main Street, Dayton, OH 45405 | 2006-11-17 |
Find all providers in zip 45405 |
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 |
---|---|---|---|---|
1386180099 | Bio-medical Applications of Ohio, Inc. | Clinic/Center | 821 S Edwin C Moses Blvd, Dayton, OH 45417 | 2017-01-19 |
1316481427 | Total Renal Care Inc | Clinic/Center | 5680 Salem Bend Dr., Dayton, OH 45426-1462 | 2016-12-08 |
1336682707 | Isd Renal Inc | Clinic/Center | 2808 Germantown St, Dayton, OH 45417-4134 | 2016-12-02 |
1710281464 | Total Renal Care Inc | Clinic/Center | 455 Turner Rd Ste B, Dayton, OH 45415-3630 | 2011-01-10 |
1194837088 | Bio-medical Applications of Texas, Inc. | Clinic/Center | 1003 N Cleveland St, Dayton, TX 77535-2131 | 2006-08-31 |
1285667667 | Dialysis Clinic Inc. | Clinic/Center | 230 White Oak Rd, Dayton, TN 37321-5200 | 2006-07-08 |
1861424707 | Peritoneal Dialysis Concepts Inc. | Clinic/Center | 1 Elizabeth Pl. 627 Edwin C Moses Blvd, Suite 2b, Dayton, OH 45417-1445 | 2006-07-07 |
1255312526 | Dialysis Centers of Dayton, LLC | Clinic/Center | 1431 Business Center Ct, Dayton, OH 45410-3300 | 2005-11-14 |
1861005241 | Fresenius Medical Care Centerville Home, LLC | Clinic/Center | 7211 Shull Rd, Dayton, OH 45424-1234 | 2020-08-26 |
1962956672 | Total Renal Care Inc | Clinic/Center | 1431 Business Center Ct, Dayton, OH 45410-3300 | 2016-08-10 |
Find all providers in DAYTON |
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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.