Provider Demographics
NPI:1811358609
Name:SOLID ROCK DIALYSIS, LLC
Entity type:Organization
Organization Name:SOLID ROCK DIALYSIS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:2400 DALLAS PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4370
Mailing Address - Country:US
Mailing Address - Phone:214-736-2700
Mailing Address - Fax:214-736-2732
Practice Address - Street 1:1580 HIGHWAY 264
Practice Address - Street 2:SUITE A
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-3302
Practice Address - Country:US
Practice Address - Phone:505-371-5518
Practice Address - Fax:505-371-5388
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S. RENAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment