SOUTHWEST KIDNEY-DAVITA DIALYSIS PARTNERS LLC


Address: 3540 E Baseline Rd Ste 110, Phoenix, AZ 85042-9628
Phone: 6024312110

SOUTHWEST KIDNEY-DAVITA DIALYSIS PARTNERS LLC (NPI# 1801050604) 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) 1801050604
Entity Type Organization
Organization Name SOUTHWEST KIDNEY-DAVITA DIALYSIS PARTNERS LLC
Other Organization Name RAVEN DIALYSIS CENTER
Practice Address 3540 E Baseline Rd Ste 110
Phoenix
AZ 85042-9628
Mailing Address 5200 Virginia Way
L&c Dept
Brentwood
TN 37027-7569
Practice Telephone 6024312110
Practice Fax Number 6024312153
Mailing Telephone 6153416814
Mailing Fax Number 8002938405
Enumeration Date 2008-07-11
Last Update Date 2018-11-14
Authorized Official Name JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
Authorized Official Telephone 2537334500
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
AZ 425841 05

Other Provider/Organization Names

Other Name Type Code
Raven Dialysis Center Doing Business As Name - Organization

Office Location

Street Address 3540 E BASELINE RD STE 110
City PHOENIX
State AZ
Zip Code 85042-9628

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1174028310 Olufemi A Omodara Pharmacist 7227 S. Central Ave, #1080, Phoenix, AZ 85042 2018-03-29
1720537699 Mary Youngblood Registered Nurse 7210 S 27th Way, Phoenix, AZ 85042 2016-10-03
1922490382 Brian Zembower Optometrist 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 2015-02-23
1417299819 Robert Murphy Portley Psychiatry & Neurology 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 2013-03-23
1972807998 Obinna Chukwuka Akubukwe Pharmacist 6006 S. Central Avenue, Phoenix, AZ 85042 2011-01-05
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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...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649730953 Scottsdale Kidney Center LLC Clinic/Center 6970 E Chauncey Ln Ste 130, Phoenix, AZ 85054-5159 2019-03-22
1932688256 Southwest Kidney Davita Dialysis Partners LLC Clinic/Center 926 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2503 2018-08-08
1982152484 Bio-medical Applications of Arizona, LLC Clinic/Center 4901 W Mcdowell Rd Ste 120, Phoenix, AZ 85035-4160 2016-09-14
1528442779 Bio-medical Applications of Arizona, LLC Clinic/Center 16605 N 28th Ave Ste 100, Phoenix, AZ 85053-7551 2015-07-17
1295070761 Calaveras Dialysis LLC Clinic/Center 5115 E Thomas Rd, Ste 115, Phoenix, AZ 85018-7914 2012-12-10
1770758526 Southwest Kidney Davita Dialysis Partners LLC Clinic/Center 4845 W Mcdowell Rd, Ste 10a, 20a, 30a, Phoenix, AZ 85035-4076 2008-04-23
1891897211 Bio-medical Applications of Arizona, LLC Clinic/Center 1957 W Dunlap Ave Ste 6c, Phoenix, AZ 85021-2985 2006-09-05
1053423954 Bio-medical Applications of Arizona LLC Clinic/Center 3421 N 7th Ave, Phoenix, AZ 85013-3635 2006-08-31
1477665289 Renal Dimensions, LLC Clinic/Center 15930 S 48th St, Suite 100, Phoenix, AZ 85048-0903 2006-08-31
1578675377 Bio-medical Applications of Arizona, Inc. Clinic/Center 1957 W Dunlap Ave, Suite 7, Phoenix, AZ 85021-2985 2006-08-31
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Competitor

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City PHOENIX
Zip Code 85042

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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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