Provider Demographics
NPI:1184942716
Name:BENDS DIALYSIS LLC
Entity type:Organization
Organization Name:BENDS DIALYSIS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:YALOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-234-0951
Mailing Address - Street 1:424 CHURCH ST
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2301
Mailing Address - Country:US
Mailing Address - Phone:615-234-0951
Mailing Address - Fax:615-234-2424
Practice Address - Street 1:16 POWDERHORN RD
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3399
Practice Address - Country:US
Practice Address - Phone:864-962-2222
Practice Address - Fax:864-228-4838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DSI RENAL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-06
Last Update Date:2010-06-15
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
SC422584Medicare Oscar/Certification