Provider Demographics
NPI:1609170257
Name:LE MARS AREA DIALYSIS SERVICES
Entity Type:Organization
Organization Name:LE MARS AREA DIALYSIS SERVICES
Other - Org Name:LE MARS AREA DIALYSIS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DONLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-546-3492
Mailing Address - Street 1:1 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3611
Mailing Address - Country:US
Mailing Address - Phone:712-541-6150
Mailing Address - Fax:712-541-6155
Practice Address - Street 1:1 1ST ST SW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3611
Practice Address - Country:US
Practice Address - Phone:712-541-6150
Practice Address - Fax:712-541-6155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment