Kings Harbor Health Services LLC

Primary specialty

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

License

7000268R Issued in NY

Legal business name

KINGS HARBOR HEALTH SERVICES LLC

Doing business as

Kings Harbor Dialysis Center

Practice address

2020 E Gun Hill Rd
Bronx, NY 10469

Phone

(718) 320-1335

NPI assigned

Oct 31, 2006

Organization subpart

No

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

Authorized official

Name

Morris Tenenbaum

Title

Member

Phone

(718) 320-1335

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kings Harbor Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1255417275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 E GUN HILL RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E GUN HILL RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10469",
            "telephone_number": "718-320-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGS HARBOR HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "TENENBAUM",
        "authorized_official_first_name": "MORRIS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-320-1335"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7000268R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02595182",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Harbor Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kings Harbor Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kingraj Pharmacy Inc
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• Kings Drugs Inc (NYS Pharmacy)
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• Shiral Kingsberry, M.S., M.H.
• Kingsbridge Adult Day Care LLC
• Kingsbridge Community Medical PC
• Kingsbridge Heights Care Ctr Inc. (Kingsbridge Heights Rehabilitation and Care Center)
• Kingsbridge Heights Lthhcp

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bronx, NY
• Providers in Bronx, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.