Provider Demographics
NPI:1033148861
Name:NRA-COSHOCTON, OHIO, LLC
Entity Type:Organization
Organization Name:NRA-COSHOCTON, OHIO, LLC
Other - Org Name:DIALYSIS SERVICES OF COSHOCTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASHIA
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:615-771-4400
Mailing Address - Street 1:730 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7289
Mailing Address - Country:US
Mailing Address - Phone:615-771-4400
Mailing Address - Fax:615-771-4401
Practice Address - Street 1:235 KENWOOD DR
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1997
Practice Address - Country:US
Practice Address - Phone:740-622-6474
Practice Address - Fax:740-622-6476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPENDING261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGOtherCLIA CERTIFICATE OF WAIVE
OHPENDINGMedicare Oscar/Certification