TOLTEC DIALYSIS LLC (NPI# 1073010518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073010518 |
| Entity Type | Organization |
| Organization Name | TOLTEC DIALYSIS LLC |
| Other Organization Name | COLLEGE CITY DIALYSIS |
| Practice Address |
2630 Donaghey Ave Conway AR 72032-0000 |
| Mailing Address |
2630 Donaghey Ave Conway AR 72032-2317 |
| Practice Telephone | 5015042474 |
| Practice Fax Number | 5015042611 |
| Mailing Telephone | 5015042474 |
| Mailing Fax Number | 5015042611 |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2020-08-21 |
| Authorized Official Name | JOHN 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 |
|---|---|---|---|
| AR | 230940134 | 05 |
| Other Name | Type Code |
|---|---|
| College City Dialysis | Doing Business As Name - Organization |
| Street Address |
2630 DONAGHEY AVE |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| 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 |
|---|---|---|---|---|
| 1306107479 | Bio-medical Applications of New Hampshire, Inc. | Clinic/Center | 21b Poliquin Dr, Conway, NH 03818-5802 | 2012-06-05 |
| 1508036922 | Bio-medical Applications of South Carolina, Inc. | Clinic/Center | 1702 Millpond Rd., Conway, SC 29527-4745 | 2008-03-03 |
| 1356453161 | Bio-medical Applications of South Carolina Inc | Clinic/Center | 838 Farrar Dr, Conway, SC 29526-8747 | 2006-08-31 |
| 1174543797 | Bio-medical Applications of North Carolina Inc | Clinic/Center | 121 North Church Street, Conway, NC 27820-0325 | 2006-07-19 |
| 1194716068 | Arkansas Renal Systems, Inc. | Clinic/Center | 2445 Christina Lane, Conway, AR 72034-4711 | 2005-10-31 |
| 1619272697 | Capes Dialysis LLC | Clinic/Center | 2445 Christina Lane, Conway, AR 72034-6798 | 2011-01-21 |
| 1912019811 | Little Rock Dialysis Inc | Clinic/Center | 201 Skyline Dr, Suite 32, Conway, AR 72032-3541 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092597 | Fort Smith Regional Dialysis Center, LLC | Clinic/Center | 256 Northridge Drive E, Van Buren, AR 72956 | 2020-08-06 |
| 1588102610 | Matheson Dialysis LLC | Clinic/Center | 9022 Landers Rd Ste E, North Little Rock, AR 72117-1599 | 2017-02-09 |
| 1871031211 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 115 E Peddicord St, Dermott, AR 71638-2314 | 2017-02-06 |
| 1821455494 | Bio-medical Applications of Mississippi, Inc. | Clinic/Center | 505 Saint Mary St, Lake Village, AR 71653-1722 | 2016-01-27 |
| 1912399601 | Ozark Dialysis LLC | Clinic/Center | 404 Camp Rd, Pocahontas, AR 72455-1487 | 2015-03-04 |
| 1447640917 | Fidelity Home Dialysis Corporation | Clinic/Center | 9421 W Markham St, Little Rock, AR 72205-2240 | 2015-02-04 |
| 1386053296 | Arkansas Staff Assisted Hemodialysis,inc | Clinic/Center | 321 Terry Pond Cv, White Hall, AR 71602-8212 | 2014-08-05 |
| 1609291202 | Little Rock Renal Services LLC | Clinic/Center | 1910 John Barrow Rd, Little Rock, AR 72204-1448 | 2014-02-19 |
| 1396178471 | Renal Treatment Centers - Southeast Lp | Clinic/Center | 6115 Baseline Rd, Ste 100, Little Rock, AR 72209 | 2013-08-13 |
| 1922346147 | Dialysis Clinic Inc. | Clinic/Center | 2800 W 10th St, Suite 510, Little Rock, AR 72204-2206 | 2013-01-23 |
| 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.