Organization · Type 2 NPI
Loup Dialysis LLC
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fenton, MO
NPI number
1154617892
Active
Practice location
1011 Bowles Ave, Ste 210
Fenton, MO 63026-2384
Fax (636) 326-8011
Mailing address
5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary | 261QE0700X | None listed |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
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About NPI 1154617892
Loup Dialysis LLC's National Provider Identifier is 1154617892, issued on Jun 21, 2011. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Fenton, MO. The record was last updated on Oct 19, 2026.