Provider Demographics
NPI:1003249137
Name:AMERICAN UNIVERSAL LLC
Entity Type:Organization
Organization Name:AMERICAN UNIVERSAL LLC
Other - Org Name:AMERICAN KIDNEY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF NURSING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-371-7878
Mailing Address - Street 1:1415 PULASKI HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5104
Mailing Address - Country:US
Mailing Address - Phone:302-836-9790
Mailing Address - Fax:302-836-9792
Practice Address - Street 1:1415 PULASKI HWY
Practice Address - Street 2:SUITE B
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5104
Practice Address - Country:US
Practice Address - Phone:302-836-9790
Practice Address - Fax:302-836-9792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1003249137Medicaid
DE082522Medicare Oscar/Certification