Provider Demographics
NPI:1205075389
Name:NAPLES HOME DIALYSIS LLC
Entity type:Organization
Organization Name:NAPLES HOME DIALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:REID
Authorized Official - Last Name:STERRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-348-8804
Mailing Address - Street 1:6101 PINE RIDGE RD
Mailing Address - Street 2:DESK 32
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3900
Mailing Address - Country:US
Mailing Address - Phone:239-348-8804
Mailing Address - Fax:239-348-8836
Practice Address - Street 1:6101 PINE RIDGE RD
Practice Address - Street 2:DESK 32
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3900
Practice Address - Country:US
Practice Address - Phone:239-348-8804
Practice Address - Fax:239-348-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment