OSCEOLA DIALYSIS (NPI# 1235558073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235558073 |
| Entity Type | Organization |
| Organization Name | OSCEOLA DIALYSIS |
| Other Organization Name | ISD RENAL INC FKA DSI RENAL INC |
| Practice Address |
1423 Pacific Ave Tacoma WA 98402-4203 |
| Mailing Address |
1332 W Keiser Ave Osceola AR 72370-2919 |
| Practice Telephone | 2533821752 |
| Mailing Telephone | 8705634901 |
| Mailing Fax Number | 8705634959 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |
| Authorized Official Name | KENT THIRY (CEO) |
| Authorized Official Telephone | 3038766000 |
| Authorized Official Credential | CHAIRMAN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
1174578595 | AR | Ambulatory Health Care Facilities |
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
04D0881442 | AR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 161527134 | 05 |
| Other Name | Type Code |
|---|---|
| ISD Renal Inc fka DSI Renal Inc | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | OSCEOLA DIALYSIS | 1332 W Keiser Ave, Osceola, AR 72370-2919 |
| Street Address |
1423 PACIFIC AVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98402-4203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225456379 | North Little Rock Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-04 |
| 1275952004 | Hempstead County Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-09 |
| 1356760185 | Miller County Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-09 |
| 1720406721 | Ashley Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| 1093133001 | Bradley County Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| 1467870469 | Degray Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| 1619395621 | Springhill Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| 1184042186 | Malvern Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| 1356769368 | Springhill Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| 1083032098 | Saline County Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548898638 | Cimberleigh Mclean | Social Worker | 2367 Tacoma Ave S Ofc 211, Tacoma, WA 98402 | 2020-04-01 |
| 1831735802 | Nickolas Justin Wise | Case Manager/Care Coordinator | 1159 Market St, Tacoma, WA 98402 | 2019-11-25 |
| 1841835436 | Michael Roy Bolden | Counselor | 1205 Tacoma Ave S., Suite 1205, Tacoma, WA 98402 | 2019-11-07 |
| 1073024980 | Megan Elizabeth Charron Mourfield | Denturist | 725 St Helens Ave S, Tacoma, WA 98402 | 2017-10-18 |
| 1104367937 | Janelle Santiago | Counselor | Mcdonald Smith Building 110, Uw Autism Center Tacoma, Tacoma, WA 98402 | 2017-03-13 |
| 1891167862 | Tanya Larson Therapy | Community/Behavioral Health | 1102 A. St., Suite 109, (suite 109), Tacoma, WA 98402 | 2015-10-29 |
| 1609242148 | Ashley Lorraine Dahlgren | Peer Specialist | 702 S 14th St., Tacoma, WA 98402 | 2015-08-19 |
| 1821416470 | Nicole Villarreal Mccormick | Acupuncturist | 711 A Ct #100, Tacoma, WA 98402 | 2014-04-01 |
| 1184055824 | Robyn Marie Callahan | Social Worker | 1102 A Street, Suite 202 B, Tacoma, WA 98402 | 2013-12-05 |
| 1679909410 | Kristin Sweet Fischer | Counselor | 708 Market St Unit 411, Tacoma, WA 98402 | 2013-09-25 |
| Find all providers in zip 98402 | ||||
| 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 |
|---|---|---|---|---|
| 1013322726 | Total Renal Care Inc | Clinic/Center | 1822 112th Street East, Suite A, Tacoma, WA 98445 | 2014-06-23 |
| 1225456379 | North Little Rock Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-04 |
| 1144423138 | Renal Life Link Inc | Clinic/Center | 3401 S 19th St, Tacoma, WA 98405-1909 | 2007-06-07 |
| 1841736329 | Renal Care Group Northwest, Inc. | Clinic/Center | 5825 Tacoma Mall Blvd, Suite 103, Tacoma, WA 98409-6906 | 2017-01-09 |
| 1386180859 | Renal Care Group Northwest, Inc. | Clinic/Center | 1717 S J St, Tacoma, WA 98405-4933 | 2017-01-09 |
| 1154867638 | Renal Care Group Northwest, Inc. | Clinic/Center | 1415 E 72nd St, Suite E, Tacoma, WA 98404-3344 | 2017-01-09 |
| 1275952004 | Hempstead County Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-09 |
| 1356760185 | Miller County Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-09 |
| 1720406721 | Ashley Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| 1093133001 | Bradley County Dialysis | Clinic/Center | 1423 Pacific Ave, Tacoma, WA 98402-4203 | 2014-04-07 |
| Find all providers in TACOMA | ||||
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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.