MAGNOLIA DIALYSIS LLC


Address: 6960 Professional Pkwy E, Units 4 & 5, Sarasota, FL 34240
Phone: 9413622864

MAGNOLIA DIALYSIS LLC (NPI# 1194125773) 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) 1194125773
Entity Type Organization
Organization Name MAGNOLIA DIALYSIS LLC
Practice Address 6960 Professional Pkwy E
Units 4 & 5
Sarasota
FL 34240
Mailing Address 5200 Virginia Way
L & C Dept
Brentwood
TN 37027-7569
Practice Telephone 9413622864
Practice Fax Number 9419074720
Mailing Telephone 6153204593
Mailing Fax Number 8002935872
Enumeration Date 2014-09-02
Last Update Date 2020-04-10
Authorized Official Name JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
Authorized Official Telephone 2537334501
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
FL 014861600 05

Office Location

Street Address 6960 PROFESSIONAL PKWY E
UNITS 4 & 5
City SARASOTA
State FL
Zip Code 34240

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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...

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Competitor

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City SARASOTA
Zip Code 34240

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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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