MILLER STREET DIALYSIS CENTER OF WAKE FOREST UNIVERSITY (NPI# 1407000540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407000540 |
| Entity Type | Organization |
| Organization Name | MILLER STREET DIALYSIS CENTER OF WAKE FOREST UNIVERSITY |
| Other Organization Name | MILLER STREET DIALYSIS CENTER |
| Practice Address |
120 Miller St Winston Salem NC 27103-2509 |
| Mailing Address |
Po Box 7710 Tifton GA 31793-7710 |
| Practice Telephone | 3367214801 |
| Practice Fax Number | 3367214861 |
| Mailing Telephone | 2293873527 |
| Mailing Fax Number | 2293862149 |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2015-03-03 |
| Authorized Official Name | TERRY L HALES JR. (ASSISTANT TREASURER) |
| Authorized Official Telephone | 3367163003 |
| 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 |
|---|---|---|---|
| NC | 3402667 | 05 |
| Other Name | Type Code |
|---|---|
| Miller Street Dialysis Center | Doing Business As Name - Organization |
| Street Address |
120 MILLER ST |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-2509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| 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 |
|---|---|---|---|---|
| 1821695164 | North Davidson Dialysis Center of Wake Forest University | Clinic/Center | 295 Millers Creek Drive, Winston Salem, NC 27127 | 2020-10-08 |
| 1073567137 | Independent Nephrology Services, Inc. | Clinic/Center | 855 Bethesda Rd, Winston Salem, NC 27103-3026 | 2006-05-20 |
| 1346218724 | North Carolina Baptist Hospital | Clinic/Center | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793571 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 1422 Meadowbrook Rd, Rocky Mount, NC 27801-6700 | 2020-08-31 |
| 1114546298 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 67 Jr Rd Ste 1200, Selma, NC 27576-3458 | 2020-04-09 |
| 1972139640 | Fresenius Medical Care Holly Springs, LLC | Clinic/Center | 5045 Old Raleigh Rd, Cary, NC 27511-6479 | 2020-03-13 |
| 1679106900 | Total Renal Care of North Carolina, LLC | Clinic/Center | 614 S Cannon Blvd, Kannapolis, NC 28083 | 2020-02-14 |
| 1699318162 | Total Renal Care of North Carolina, LLC | Clinic/Center | 246 Olmsted Blvd Ste E, Pinehurst, NC 28374-6005 | 2019-10-28 |
| 1497398416 | Total Renal Care of North Carolina, LLC | Clinic/Center | 2621 Hendersonville Rd, Arden, NC 28704-9226 | 2019-10-22 |
| 1780231894 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 2360 Williamwood Lane, Fayetteville, NC 28314 | 2019-08-22 |
| 1962063156 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 565 Regency Blvd, Winterville, NC 28590-5503 | 2019-06-27 |
| 1295399343 | Total Renal Care of North Carolina, LLC | Clinic/Center | 219 Martin Luther King Jr Dr, Bladenboro, NC 28320 | 2019-04-24 |
| 1174086698 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 105 Adair Dr, Goldsboro, NC 27530-4516 | 2019-04-11 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on MILLER STREET DIALYSIS CENTER OF WAKE FOREST UNIVERSITY.
| 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.