GUAM DIALYSIS CENTER, INC. (NPI# 1831161728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831161728 |
| Entity Type | Organization |
| Organization Name | GUAM DIALYSIS CENTER, INC. |
| Other Organization Name | GUAM RENAL CARE |
| Practice Address |
265 Chalan Santo Papa Hagatna GU 96910 |
| Mailing Address |
1 World Trade Ctr 2500 Long Beach CA 90831-0002 |
| Practice Telephone | 6714753600 |
| Practice Fax Number | 6714772759 |
| Mailing Telephone | 5624958075 |
| Mailing Fax Number | 5624958076 |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JERRY GREEN (SECRETARY) |
| Authorized Official Telephone | 5624958075 |
| 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 |
|---|---|---|---|
| GU | 191 | 05 |
| Other Name | Type Code |
|---|---|
| GUAM RENAL CARE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053383059 | Guam Dialysis Center, Inc. | Clinic/Center | 633 Governor Carlos B. Camacho Rd, 106, Tamuning, GU 96913 | 2006-02-03 |
| Street Address |
265 CHALAN SANTO PAPA |
| City | HAGATNA |
| State | GU |
| Zip Code | 96910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576230 | Bo Henry Marshall | Physician Assistant | 302 S Route 4 Ste 207, Hagatna, GU 96910 | 2020-07-28 |
| 1972133361 | Elizabeth Quilitis Camacho | Licensed Practical Nurse | 127 2nd St Ocean Vista Tiyan, Maite, GU 96910 | 2020-01-24 |
| 1588200497 | Carrie Margeson | Pharmacist | Bldg #50 Farenholt Ave, Tutuhan, GU 96910 | 2019-11-26 |
| 1265075188 | Amy C Romero | Counselor | 144 Afia Building Suite 201, Hagatna, GU 96910 | 2019-10-23 |
| 1710549589 | Carmela Santos | Registered Nurse | Bldg #50, Farenholt Ave, Tutuhan, GU 96910 | 2019-07-02 |
| 1912469404 | Daniel A. Duenas | Social Worker | 222 Chalan Santo Papa Reflection Center, Hagatna, GU 96910 | 2019-04-03 |
| 1598238891 | Steven Butler | Counselor | 144 Aspinal Ave., Afia Bld. Suite 202, Hagatna, GU 96910 | 2019-01-09 |
| 1790275675 | Evangeline Claassens | Nurse Practitioner | 736 South Route 4, Suite 103, Sinajana, GU 96910 | 2018-05-16 |
| 1356839575 | Evergreen Health Center LLC | Clinic/Center | 520 Route 8, Maite, GU 96910 | 2018-04-23 |
| 1902312382 | Sarah Burton | Pharmacist | Building 50 Farenholt Blvd, Agana Heights, GU 96910 | 2017-12-20 |
| Find all providers in zip 96910 | ||||
| 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 |
|---|---|---|---|---|
| 1881116697 | Usrc Finegayan LLC | Clinic/Center | 781 Route 3, Ste 101, Dededo, GU 96929-6913 | 2017-07-13 |
| 1053383059 | Guam Dialysis Center, Inc. | Clinic/Center | 633 Governor Carlos B. Camacho Rd, 106, Tamuning, GU 96913 | 2006-02-03 |
| 1790090678 | Rsa-tumon, LLC | Clinic/Center | 1406 N Marine Corps Dr, Tamuning, GU 96913-4310 | 2010-08-16 |
| 1588849541 | Rsa - Guam, LLC | Clinic/Center | 736 Route 4, Suite 101, Sinajana, GU 96910-3368 | 2008-01-08 |
| 1295910255 | Rsa - Guam, LLC | Clinic/Center | 633 Gov Carlos G Camacho Rd, Suite 106, Tamuning, GU 96913-3194 | 2008-01-08 |
| 1396934253 | Guam Memorial Hospital | Clinic/Center | 850 Governor Carlos Camacho Road, Oka Tamuning, GU 96913-3128 | 2007-10-17 |
| 1346436441 | Renal Centers of Guam, LLC | Clinic/Center | 600 Harmon Loop Rd, Dededo, GU 96929-6536 | 2007-09-21 |
| 1447441670 | American Dialysis Center, Inc. | Clinic/Center | 1406 N Marine Corps Dr, Tamuning, GU 96913-4311 | 2007-08-05 |
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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.