Provider Demographics
NPI:1821626029
Name:KIDNEY HOME CARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:KIDNEY HOME CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-519-5318
Mailing Address - Street 1:10124 CLEMMONS RD
Mailing Address - Street 2:
Mailing Address - City:FORTWORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-2063
Mailing Address - Country:US
Mailing Address - Phone:601-519-5318
Mailing Address - Fax:
Practice Address - Street 1:10124 CLEMMONS RD
Practice Address - Street 2:
Practice Address - City:FORTWORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-2063
Practice Address - Country:US
Practice Address - Phone:601-519-5318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysisGroup - Multi-Specialty