Provider Demographics
NPI:1386640217
Name:COMMUNITY DIALYSIS UNITS, LLC
Entity Type:Organization
Organization Name:COMMUNITY DIALYSIS UNITS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LINDESMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-649-8057
Mailing Address - Street 1:4685 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2379
Mailing Address - Country:US
Mailing Address - Phone:330-649-9300
Mailing Address - Fax:330-649-4058
Practice Address - Street 1:270 E STATE ST
Practice Address - Street 2:STE 110
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4309
Practice Address - Country:US
Practice Address - Phone:330-821-1657
Practice Address - Fax:330-821-1735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0745DC261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2519135Medicaid
OH362669Medicare ID - Type Unspecified