Guam Dialysis Center, Inc.

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

GUAM DIALYSIS CENTER, INC.

Practice address

633 Governor Carlos B. Camacho Rd
106
Tamuning, GU 96913

Phone

(671) 646-3517

Fax

(671) 646-3531

NPI assigned

Feb 3, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jerry Green

Title

Secretary

Phone

(562) 495-8075

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Guam Dialysis Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Guam Dialysis Center, Inc.

  dba Guam Renal Care

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Hagatna, GU
  • NPI 1831161728
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053383059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WORLD TRADE CTR",
            "address_2": "2500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908310002",
            "telephone_number": "562-495-8075",
            "fax_number": "562-495-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GOVERNOR CARLOS B. CAMACHO RD",
            "address_2": "106",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-646-3517",
            "fax_number": "671-646-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUAM DIALYSIS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "562-495-8075",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guahan Physicians and Consultants (Latte Stone cancer Care)
• Guahan Specialty and Wellness Center, LLC
• Guam Anesthesia and Pain Service
• Guam Anesthesia Services
• Guam Dermatology Institute LLC (Guam Dermatology Institute)
• Guam E.N.T., LLC
• Guam Geriatrics Clinic
• Guam Hematology Oncology Associates, Inc.
• Guam Medical Care, LLC
• Guam Medical Equipment and Supplies, LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tamuning, GU
• Providers in Tamuning, GU by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.