Mena Dialysis

Primary specialty

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

License

04D1075322 Issued in AR

Legal business name

MENA DIALYSIS

Practice address

1423 Pacific Ave
Tacoma, WA 98402-4203

Phone

(253) 382-1752

NPI assigned

Apr 4, 2014

Organization subpart

No

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

Authorized official

Name

Kent Thiry, CHAIRMAN

Title

Ceo

Phone

(303) 876-6000

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Mena Dialysis2 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.

• Mena Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mena, AR
  • NPI 1477744670
  NPD tax ID

Locations

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1124446208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CRESTWOOD CIR",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719535516",
            "telephone_number": "479-394-8085",
            "fax_number": "479-394-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024203",
            "telephone_number": "253-382-1752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENA DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "THIRY",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-876-6000",
        "authorized_official_credential": "CHAIRMAN"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AR",
            "license": "04D1075322",
            "primary": true
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AR",
            "license": "1477744670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167685134",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avelina Melnichuk
• Melody Comfort Adult Family Home LLC
• Jamie Melsness
• Bryant Cameron Melton, OTR/L
• Kristal Celeste Melvin, CRNP
• Cherryl Anne Menapace, NP
• Kyle Menday, RN
• Sierra Mendez
• Ulysses Mendez, LMT
• Jasmine Mendiola, MASSAGE THERAPIST

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Tacoma, WA
• Providers in Tacoma, WA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; 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.