Provider Demographics
NPI:1043367063
Name:AMBULATORY RENAL SERVICES, INC.
Entity Type:Organization
Organization Name:AMBULATORY RENAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:LENNARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-644-2264
Mailing Address - Street 1:806 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46012-4007
Mailing Address - Country:US
Mailing Address - Phone:765-644-2264
Mailing Address - Fax:765-644-8655
Practice Address - Street 1:806 E 9TH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-4007
Practice Address - Country:US
Practice Address - Phone:765-644-2264
Practice Address - Fax:765-644-8655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN25088-A343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)