Provider Demographics
NPI:1235673724
Name:NXKC SAGINAW, LLC
Entity Type:Organization
Organization Name:NXKC SAGINAW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-239-1492
Mailing Address - Street 1:5375 HAMPTON PL
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9478
Mailing Address - Country:US
Mailing Address - Phone:989-341-5260
Mailing Address - Fax:989-401-9440
Practice Address - Street 1:5375 HAMPTON PL
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9478
Practice Address - Country:US
Practice Address - Phone:989-341-5260
Practice Address - Fax:989-401-9440
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NXSTAGE KIDNEY CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment