Provider Demographics
NPI:1083669782
Name:DSI RENAL INC
Entity Type:Organization
Organization Name:DSI RENAL INC
Other - Org Name:NRI COBB COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF REIMBURSEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-0134
Mailing Address - Street 1:511 UNION ST
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-1733
Mailing Address - Country:US
Mailing Address - Phone:615-467-0134
Mailing Address - Fax:615-234-2422
Practice Address - Street 1:506 ROSWELL ST SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-4100
Practice Address - Country:US
Practice Address - Phone:770-426-5110
Practice Address - Fax:770-426-9402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-02-06
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
112675Medicare Oscar/Certification