Grand Concourse Dialysis Facility

LBN: Concourse Replacement Llc
Grand Concourse Dialysis Facility is an health care organization with primary practice located at 1780 Grand Concourse , Bronx NY 10457-5500. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Concourse Replacement Llc can be contacted via phone (718) 583-1800, or through Licciardi, Dominic via phone (718) 987-5942.

Contact Information

Primary practice address
1780 Grand Concourse Bronx NY 10457-5500
Phone: (718) 583-1800
Fax: (718) 583-4160
Website:
Map and Directions
Authorized official contact:
Name: Licciardi, Dominic
Phone: (718) 987-5942

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1740400431
LBN Legal business name Concourse Replacement Llc
DBA Doing business as Grand Concourse Dialysis Facility
Authorized official Licciardi, Dominic
Entity Organization
Organization subpart 1 No
Enumeration date Apr 26th, 2007
Last updated Oct 12th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740400431 NPPES
New York MEDICAID 02986203

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