LYNDALE DIALYSIS LLC (NPI# 1033584248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033584248 |
| Entity Type | Organization |
| Organization Name | LYNDALE DIALYSIS LLC |
| Other Organization Name | DEER PARK DIALYSIS |
| Practice Address |
4401 Mack Rd Sacramento CA 95823-4545 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9167383575 |
| Practice Fax Number | 9164292368 |
| Mailing Telephone | 6153416765 |
| Mailing Fax Number | 8337829089 |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2019-05-09 |
| 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 |
|---|---|---|---|
| CA | 1033584248 | 05 |
| Other Name | Type Code |
|---|---|
| Deer Park Dialysis | Doing Business As Name - Organization |
| Street Address |
4401 MACK RD |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95823-4545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343422 | Renee Yvonne Friesner | Registered Nurse | 6965 65th Street, Sacramento, CA 95823 | 2020-10-12 |
| 1790392165 | Amanda Moore | Technician | 6445 Village Center Dr, Building 7 Apt 101, Sacramento, CA 95823 | 2020-09-29 |
| 1114562766 | Daniel & Max, LLC | Optometrist | 4200 Florin Road, Suite C, Florin, CA 95823 | 2019-11-07 |
| 1396393823 | Lannon Hope Gustafson | Counselor | 8573 E Southgate Dr., Sacramento, CA 95823 | 2019-08-28 |
| 1932768280 | Sprenger Behavioral Medicine, Inc | Psychiatry & Neurology | 7601 Hospital Drive Suite 202, Suite 202, Sacramento, CA 95823 | 2019-06-11 |
| 1306316880 | Evin Johnson | Case Manager/Care Coordinator | 7000 Franklin Blvd Suite 625, Sacramento, CA 95823 | 2018-11-28 |
| 1902373095 | Alexandra L Bourcy | Family Medicine | 7275 E Southgate Dr Ste 204-206, Sacramento, CA 95823 | 2018-10-27 |
| 1891298923 | Nicholas Joseph Henderson | Behavior Technician | 6500 47th Street Apt#76, Sacramento, CA 95823 | 2018-03-15 |
| 1427567098 | Luz Maria Udave | Behavior Technician | 5435 Mack Rd Apt 87, Sacramento, CA 95823 | 2017-09-26 |
| 1417474743 | Elizabeth Smithers | Behavior Technician | 5545 Sky Parkway #202, Sacramento, CA 95823 | 2017-08-28 |
| Find all providers in zip 95823 | ||||
| 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 |
|---|---|---|---|---|
| 1871128173 | Dialysis Clinic Inc | Clinic/Center | 1955 36th St, Sacramento, CA 95816-6634 | 2020-03-06 |
| 1780173724 | Wellbound of Emeryville LLC | Clinic/Center | 3 Park Center Dr Ste 120, Sacramento, CA 95825 | 2018-05-04 |
| 1235642950 | Regents of The University of California | Clinic/Center | 2521 Stockton Blvd Ste 2200, Sacramento, CA 95817-2207 | 2017-11-16 |
| 1841741857 | Landor Dialysis LLC | Clinic/Center | 2980 Advantage Way, Sacramento, CA 95834-9666 | 2016-10-14 |
| 1568847929 | Glosser Dialysis LLC | Clinic/Center | 2624 Stockton Blvd, Sacramento, CA 95817-2210 | 2015-07-28 |
| 1477807139 | Dialysis Clinic Inc. | Clinic/Center | 1545 Meadowview Rd, Suites 130 - 180, Sacramento, CA 95832-1081 | 2012-11-02 |
| 1790051761 | Satellite Healthcare Inc | Clinic/Center | 646 N Market Blvd, Sacramento, CA 95834-1248 | 2012-03-23 |
| 1427322411 | Goliad Dialysis LLC | Clinic/Center | 251 Lathrop Way, Ste A, Sacramento, CA 95815-4223 | 2012-03-08 |
| 1184906745 | Rai Care Centers of Northern California I LLC | Clinic/Center | 4660 Mack Rd, Suite 168, Sacramento, CA 95823-8200 | 2011-09-09 |
| 1093030504 | Griffin Dialysis LLC | Clinic/Center | 8243 E Stockton Blvd Ste 100, Sacramento, CA 95828-8204 | 2010-03-29 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95823 |
Please comment or provide details below to improve the information on LYNDALE DIALYSIS LLC.
| 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.