Organization · Type 2 NPI

Randolph Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fort Wayne, IN

NPI number 1659796233 Active

Practice location

6721 Old Trail Rd, Ste 100
Fort Wayne, IN 46809-2655

Call (260) 478-8582 Map

Fax (260) 478-8566

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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NPI record

NPI: 1659796233
Entity type: Organization (Type 2)
Issued: Feb 19, 2014
Last updated: Dec 15, 2022
Status: Active

Other names

<unavail>
Three Rivers Dialysis · doing business as
Three Rivers Dialysis · doing business as

Authorized official

John Winstel
Chief Accounting Officer
(253) 733-4501

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About NPI 1659796233

Randolph Dialysis LLC's National Provider Identifier is 1659796233, issued on Feb 19, 2014. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Fort Wayne, IN. The record was last updated on Dec 15, 2022.