WALLOWA DIALYSIS LLC


Address: 2148 W 4th St, Ontario, OH 44906-1200
Phone: 4197474039

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).

Provider Overview

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

Taxonomy

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 Provider Identifier

State Issuer Identifier Type Code
OH 0100014 05

Other Provider/Organization Names

Other Name Type Code
Mid Ohio Dialysis Doing Business As Name - Organization

Office Location

Street Address 2148 W 4TH ST
City ONTARIO
State OH
Zip Code 44906-1200

Providers in the same zip code

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 Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City ONTARIO
Zip Code 44906

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Dataset Information

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.

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