SOUTHEASTERN RENAL DIALYSIS L.C. – NPI #1144490178
Clinic/Center

SOUTHEASTERN RENAL DIALYSIS L.C. is an AHC clinic located in FAIRFIELD, IA. NPPES has assigned the NPI number 1144490178 to SOUTHEASTERN RENAL DIALYSIS L.C. on March 05, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHEASTERN RENAL DIALYSIS L.C. below.

NPI Profile for
SOUTHEASTERN RENAL DIALYSIS L.C.

NPI Number
1144490178
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHEASTERN RENAL DIALYSIS L.C.
Primary location
2000 A S MAIN ST
FAIRFIELD, IA 52556
Phone: (641) 469-3313 Fax:
Mailing address
507 S WHITE ST
MT PLEASANT, IA 52641-2625
Phone: Fax:
Organization Subpart
Yes - SOUTHEASTERN RENAL DIALYSIS L.C. is subpart of another organization.
Authorized Official
MARY LIECHTY
ADMINISTRATOR
Phone: (319) 385-6728
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)		 IA

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.