Organization · Type 2 NPI

Elgin Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Fort Stockton, TX

NPI number 1790046159 Active

Practice location

387 Interstate 10 W, Ste C
Fort Stockton, TX 79735-2700

Call (432) 336-8041 Map

Fax (432) 336-8205

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	110157 (TX)

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1790046159
Entity type: Organization (Type 2)
Issued: Jun 1, 2012
Last updated: Apr 9, 2019
Status: Active

Other names

<unavail>
Fort Stockton Dialysis · doing business as
Fort Stockton Dialysis · doing business as

Authorized official

James K Hilger
Chief Accounting Officer
(253) 733-4500

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1790046159

Elgin Dialysis LLC's National Provider Identifier is 1790046159, issued on Jun 1, 2012. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Fort Stockton, TX. The record was last updated on Apr 9, 2019.