WALLOWA DIALYSIS LLC (NPI# 1023360955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023360955 |
| Entity Type | Organization |
| Organization Name | WALLOWA DIALYSIS LLC |
| Other Organization Name | MID OHIO DIALYSIS |
| Practice Address |
2148 W 4th St Ontario OH 44906-1200 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 4197474039 |
| Practice Fax Number | 4197474046 |
| Mailing Telephone | 6152383051 |
| Mailing Fax Number | 8002468346 |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2019-10-01 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0100014 | 05 |
| Other Name | Type Code |
|---|---|
| Mid Ohio Dialysis | Doing Business As Name - Organization |
| Street Address |
2148 W 4TH ST |
| City | ONTARIO |
| State | OH |
| Zip Code | 44906-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920155 | Jonathan Clevenger | Pharmacist | 1455 North Lexington-springmill Road, Ontario, OH 44906 | 2020-10-21 |
| 1366083297 | Jennifer Robin Young | Technician | 60 Sherman Ave, Mansfield, OH 44906 | 2019-10-02 |
| 1639721905 | Lora Harris | Nurse Practitioner | 1029 S. Trimble Rd, Mansfield, OH 44906 | 2019-07-16 |
| 1871098855 | Med Gear Plus, LLC | Durable Medical Equipment & Medical Supplies | 1041 Park Ave W, Mansfield, OH 44906 | 2018-03-29 |
| 1912401209 | Bradley Anderson | Dietitian, Registered | 1025 South Trimble Rd., Mansfield, OH 44906 | 2018-03-21 |
| 1104325182 | Nancy Labaki | Speech-Language Pathologist | 2011 W. Fourth St., Mansfield, OH 44906 | 2018-02-06 |
| 1720518319 | Stephen Anderson | Counselor | 680 Park Ave W., Mansfield, OH 44906 | 2017-06-15 |
| 1427422518 | Jill A Waite | Counselor | 33 S. Lexington-springmill Road, Mansfield, OH 44906 | 2015-11-30 |
| 1992125397 | Taryn Boyd | Physical Therapist | 1025 S Trimble, Mansfield, OH 44906 | 2014-04-24 |
| 1356760870 | Sarah Brandyberry | Social Worker | 1025 S. Trimble Rd., Mansfield, OH 44906 | 2014-04-11 |
| Find all providers in zip 44906 | ||||
| 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 |
|---|---|---|---|---|
| 1437538618 | Trailstone Dialysis LLC | Clinic/Center | 2403 S Vineyard Ave, Ste D, Ontario, CA 91761-6471 | 2015-05-21 |
| 1992971774 | Ontario Dialysis Center, Inc. | Clinic/Center | 1001 West 6th Street, Ontario, CA 91764 | 2008-05-01 |
| 1356549455 | Dialysis Center of Ontario LLC | Clinic/Center | 2850 Inland Empire Blvd Ste C, Ontario, CA 91764-4659 | 2007-07-10 |
| 1770520488 | Ontario Dialysis Center,inc | Clinic/Center | 1001 W 6th St, Ontario, CA 91762-1209 | 2006-06-01 |
| 1184687345 | Ontario Dialysis Center LLC | Clinic/Center | 1950 S Grove Ave, Ste 101, Ontario, CA 91761-5693 | 2006-04-10 |
| 1073504635 | Saint Alphonsus Nephrology Center | Clinic/Center | 515 East Ln, Ontario, OR 97914-3953 | 2005-11-02 |
| 1396027181 | Kaiser Foundation Hospitals | Clinic/Center | 2295 S Vineyard Ave, Ontario, CA 91761-7925 | 2011-09-16 |
| 1922333764 | Renal Treatment Centers California Inc | Clinic/Center | 1950 S Grove Ave, Ste 101-105, Ontario, CA 91761-5693 | 2009-10-13 |
| 1053363689 | Total Renal Care Inc | Clinic/Center | 515 East Ln, Ontario, OR 97914-3953 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744616 | Akron Renal Care Group, LLC | Clinic/Center | 2583 Center Rd, Hinckley, OH 44233-9561 | 2020-09-11 |
| 1366057747 | Akron Renal Care Group, LLC | Clinic/Center | 9200 Staples Dr Ste A, Streetsboro, OH 44241-3950 | 2020-09-11 |
| 1518570886 | Independent Dialysis Group Northeast Ohio LLC | Clinic/Center | 48444 Bell School Rd Ste 4, Calcutta, OH 43920-9646 | 2020-08-26 |
| 1871106401 | Akron Renal Care Group, LLC | Clinic/Center | 401 Devon Pl Ste 100, Kent, OH 44240-6481 | 2020-08-24 |
| 1558985663 | Wyandot Dialysis Clinic LLC | Clinic/Center | 1207 E Wyandot Ave, Upper Sandusky, OH 43351-9647 | 2020-06-04 |
| 1245854876 | Concerto Ohio LLC | Clinic/Center | 2111 S Green Rd, South Euclid, OH 44121-3350 | 2020-05-29 |
| 1548899602 | Northeast Ohio Home Dialysis LLC | Clinic/Center | 2819 S Hayes Ave Ste 8, Sandusky, OH 44870-5391 | 2020-04-02 |
| 1982242954 | Center for Dialysis Care Beachwood Home Care LLC | Clinic/Center | 3755 Orange Pl Ste 103, Beachwood, OH 44122-4455 | 2019-12-20 |
| 1639715808 | Bullock Dialysis LLC | Clinic/Center | 2290 Ferguson Rd, Cincinnati, OH 45238 | 2019-11-22 |
| 1912554486 | Usrc Tiffin, LLC | Clinic/Center | 100 Shaffer Park Dr Ste A, Tiffin, OH 44883-8536 | 2019-08-20 |
| Find all providers with the same taxonomy | ||||
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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.