Macab Dialysis LLC

Primary specialty

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

Legal business name

MACAB DIALYSIS LLC

Doing business as

Garfield County Dialysis

Practice address

204 S Van Buren St
Enid, OK 73703-5812

Phone

(580) 237-1264

Fax

(580) 237-1463

NPI assigned

Feb 24, 2017

Organization subpart

No

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

Authorized official

Name

John Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Garfield County Dialysis Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1356881346",
    "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",
            "telephone_number": "615-620-4268",
            "fax_number": "877-238-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737035812",
            "telephone_number": "580-237-1264",
            "fax_number": "580-237-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACAB DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "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": "200770970A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garfield County Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Garfield County Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christanie Ann Lynn
• Jessa K Lynni, M.S.
• Mitchell Louis Lyon, LPC
• Pamela Kay Lytle, DPH
• James R Mabry, D.D.S.
• Elena Mackey Sommer
• Making a Difference Inc.
• Chander Kamal Malhotra, MD
• Suman Malhotra, MD
• Joshua Malone, PHARMD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Enid, OK
• Providers in Enid, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.