Garden Grove Harbor Dialysis

LBN: Edisto Dialysis Llc
Garden Grove Harbor Dialysis is an health care organization with primary practice located at 13054 N Harbor Blvd , Garden Grove CA 92843-1744. 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. Edisto Dialysis Llc can be contacted via phone (714) 539-3395, or through Wey, Samuel T. via phone (615) 341-6641.

Contact Information

Primary practice address
13054 N Harbor Blvd Garden Grove CA 92843-1744
Phone: (714) 539-3395
Fax: (714) 539-3467
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel T.
Phone: (615) 341-6641

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X 550002921 California

Profile Details

NPI number 1619397700
LBN Legal business name Edisto Dialysis Llc
DBA Doing business as Garden Grove Harbor Dialysis
Authorized official Wey, Samuel T.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 16th, 2014
Last updated Jun 7th, 2024 - 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 1619397700 NPPES
California MEDICAID 1619397700

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