Ardmore Dialysis Ranch

LBN: Jacinto Dialysis Llc
Ardmore Dialysis Ranch is an health care organization with primary practice located at 2617 Crossroads Dr , Ardmore OK 73401-2574. 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. Jacinto Dialysis Llc can be contacted via phone (580) 490-9844, or through Wey, Samuel via phone (615) 341-6641.

Contact Information

Primary practice address
2617 Crossroads Dr Ardmore OK 73401-2574
Phone: (580) 490-9844
Fax: (580) 490-9831
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel
Phone: (615) 341-6641

Health care specialties

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

Profile Details

NPI number 1457697575
LBN Legal business name Jacinto Dialysis Llc
DBA Doing business as Ardmore Dialysis Ranch
Authorized official Wey, Samuel
Entity Organization
Organization subpart 1 No
Enumeration date Dec 18th, 2012
Last updated Nov 28th, 2023 - about 3 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 1457697575 NPPES
Oklahoma MEDICAID 200519620A

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