Active NPI
Liberty RC Inc
Doing business as Southtowns Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Hamburg, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- LIBERTY RC INC
- Doing business as
- Southtowns Dialysis Center
- Practice address
- 4910 Camp Rd
Ste 100
Hamburg, NY 14075-2617 - Phone
- (716) 649-4072
- Fax
- (716) 649-1937
- NPI assigned
- Aug 30, 2010
- Last updated
- May 29, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samuel Wey
- Title
- Assistant Secretary
- Phone
- (615) 341-6641
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
4910 Camp Rd
Ste 100
Hamburg, NY 14075-2617
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03335568 | Medicaid | NY |
Other names 1
- Southtowns Dialysis Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100916000402 | NY | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 9436199304 | Practice locations: Hamburg, NY |
Other NPIs with the same Medicare PAC ID 13
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Dyker Heights Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Brooklyn, NY
- NPI 1104155894
9436199304
-
dba Cleve Hill Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Amherst, NY
- NPI 1104855311
9436199304
-
dba Yonkers East Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Yonkers, NY
- NPI 1164670113
9436199304
-
dba Dunkirk Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Dunkirk, NY
- NPI 1205353513
9436199304
-
dba Hudson Valley Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Tarrytown, NY
- NPI 1265461487
9436199304
-
dba Celia Dill Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Carmel, NY
- NPI 1477582690
9436199304
-
dba White Plains Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- White Plains, NY
- NPI 1578591152
9436199304
-
dba Niagara Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Niagara Falls, NY
- NPI 1619377330
9436199304
-
dba Lock City Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Lockport, NY
- NPI 1699261321
9436199304
-
dba Renal Care of Buffalo
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- West Seneca, NY
- NPI 1730118852
9436199304
-
dba Niagara Falls Kidney Care Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Niagara Falls, NY
- NPI 1740588755
9436199304
-
dba Port Chester Dialysis and Renal Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Purchase, NY
- NPI 1982632543
9436199304
Care Compare: Dialysis facility
Medicare Care Compare- Listed as
- DaVita Southtowns Dialysis
- Overall star rating
- Ownership
- Profit
- Certified
- Feb 24, 2011
- Medicare certification status
- Active
- Chain
- DaVita
- Dialysis stations
- 25
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2017045 | Southtowns Dialysis | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Liberty RC Inc
Other organizations with this tax ID 13
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Dyker Heights Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Brooklyn, NY
- NPI 1104155894
-
dba Cleve Hill Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Amherst, NY
- NPI 1104855311
-
dba Yonkers East Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Yonkers, NY
- NPI 1164670113
-
dba Dunkirk Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Dunkirk, NY
- NPI 1205353513
-
dba Hudson Valley Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Tarrytown, NY
- NPI 1265461487
-
dba Celia Dill Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Carmel, NY
- NPI 1477582690
-
dba White Plains Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- White Plains, NY
- NPI 1578591152
-
dba Niagara Dialysis Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Niagara Falls, NY
- NPI 1619377330
-
dba Lock City Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Lockport, NY
- NPI 1699261321
-
dba Renal Care of Buffalo
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- West Seneca, NY
- NPI 1730118852
-
dba Niagara Falls Kidney Care Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Niagara Falls, NY
- NPI 1740588755
-
dba Port Chester Dialysis and Renal Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Purchase, NY
- NPI 1982632543
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283126400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780012800000",
"number": "1184930083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "L&C DEPT",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4910 CAMP RD",
"address_2": "STE 100",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140752617",
"telephone_number": "716-649-4072",
"fax_number": "716-649-1937"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIBERTY RC INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-08-30",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A",
"authorized_official_last_name": "WEY",
"authorized_official_first_name": "SAMUEL",
"authorized_official_title_or_position": "ASSISTANT SECRETARY",
"authorized_official_telephone_number": "615-341-6641"
},
"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": "03335568",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Southtowns Dialysis Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Hamburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.