Provider Demographics
NPI:1073569687
Name:DSI RENAL INC
Entity Type:Organization
Organization Name:DSI RENAL INC
Other - Org Name:DSI PLEASANTBURG DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE PARALEGAL
Authorized Official - Prefix:MS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCKINNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-234-1160
Mailing Address - Street 1:424 CHURCH STREET
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2387
Mailing Address - Country:US
Mailing Address - Phone:615-777-8201
Mailing Address - Fax:615-234-2489
Practice Address - Street 1:110 CHALMERS ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-1351
Practice Address - Country:US
Practice Address - Phone:864-558-2365
Practice Address - Fax:864-299-4760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2011-02-24
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
422579Medicare Oscar/Certification