LIBERTY DIALYSIS - SOUTH HILL, LLC (NPI# 1467752261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467752261 |
| Entity Type | Organization |
| Organization Name | LIBERTY DIALYSIS - SOUTH HILL, LLC |
| Practice Address |
201a E Ferrell St South Hill VA 23970 |
| Mailing Address |
7650 Se 27th St Suite 200 Mercer Island WA 98040-3060 |
| Practice Telephone | 4344473151 |
| Mailing Telephone | 2062365001 |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2013-01-23 |
| Authorized Official Name | RYAN B PARDO (VICE PRESIDENT) |
| Authorized Official Telephone | 2062365001 |
| 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 |
| Street Address |
201A E FERRELL ST |
| City | SOUTH HILL |
| State | VA |
| Zip Code | 23970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043784606 | Elizabeth Jene Ezell | Dental Hygienist | 604 N. Thomas St., South Hill, VA 23970 | 2019-01-17 |
| 1821576901 | Mackenzie Jean Blackwell | Dental Hygienist | 604 N. Thomas St, South Hill, VA 23970 | 2018-08-01 |
| 1316459357 | Bernita Danica Boyd | Contractor | 436 Theater Rd, South Hill, VA 23970 | 2017-10-31 |
| 1194242909 | More Transport LLC | Non-emergency Medical Transport (VAN) | 651 Clearview Dr, South Hill, VA 23970 | 2017-08-23 |
| 1912423534 | Larry D Warren | Driver | 730 Hite Street, Po Box 896, South Hill, VA 23970 | 2017-08-15 |
| 1902320658 | Lakika Lyshon Hicks | Non-emergency Medical Transport (VAN) | 74 Hudgins Road, South Hill, VA 23970 | 2017-08-02 |
| 1053835561 | Vernice Luevine Lewis | Driver | 11525 Highway One, South Hill, VA 23970 | 2017-07-27 |
| 1407376924 | Building Blocks To Success LLC | Occupational Therapist | 20429 Hwy Forty-seven, South Hill, VA 23970 | 2017-06-26 |
| 1316477136 | Eric Blackwell | Driver | 248 Circle Dr, South Hill, VA 23970 | 2017-06-14 |
| 1619341443 | North View Day Support LLC | Day Training, Developmentally Disabled Services | 359 Saffold Road, South Hill, VA 23970 | 2015-11-17 |
| Find all providers in zip 23970 | ||||
| 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 |
|---|---|---|---|---|
| 1851465629 | Community Memorial Healthcenter | Clinic/Center | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497363253 | Fresenius Medical Care Kempsville Home, LLC | Clinic/Center | 6161 Kempsville Cir Ste B, Norfolk, VA 23502-3932 | 2020-07-17 |
| 1760004360 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 7525 Tidewater Dr Ste 37, Norfolk, VA 23505-3700 | 2020-05-18 |
| 1871113746 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 165 Market St Ste 6, Onancock, VA 23417-4233 | 2020-04-21 |
| 1447889399 | Legacy Dialysis of Virginia | Clinic/Center | 211 Gibson St Nw Ste 209, Leesburg, VA 20176-2115 | 2020-04-03 |
| 1457907917 | Renal Treatment Centers - Mid-atlantic, Inc. | Clinic/Center | 570 Westgate Shopping Ctr, Bedford, VA 24523-2643 | 2019-08-12 |
| 1306492848 | Renal Treatment Centers- Mid-atlantic, Inc. | Clinic/Center | 145 Holt Garrison Pkwy Ste 340, Danville, VA 24540-5956 | 2019-08-12 |
| 1043873664 | Branbur Dialysis LLC | Clinic/Center | 4650 Puddledock Rd, Prince George, VA 23875-1235 | 2019-04-18 |
| 1811454226 | Mohansic Dialysis, LLC | Clinic/Center | 8123 Richmond Hwy, Alexandria, VA 22309-3613 | 2019-02-22 |
| 1720552110 | Shawano Dialysis, LLC | Clinic/Center | 13859 Village Place Dr, Midlothian, VA 23114-3503 | 2019-01-18 |
| 1528533171 | Gansett Dialysis, LLC | Clinic/Center | 8605 Westwood Center Dr Ste 100, Vienna, VA 22182-2231 | 2018-10-10 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HILL |
| Zip Code | 23970 |
Please comment or provide details below to improve the information on LIBERTY DIALYSIS - SOUTH HILL, 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.