Historic Dialysis LLC

Primary specialty

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

Legal business name

HISTORIC DIALYSIS LLC

Practice address

1501 N Washington St
Forrest City, AR 72335-2152

Phone

(870) 494-4022

Fax

(870) 494-4769

NPI assigned

Jan 26, 2009

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Vice President

Phone

(253) 382-1919

Specialties & licenses 1

Addresses

Other names 1

• Forrest City Dialysis Doing business as

Member of 1

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

• Bainbridge Dialysis LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
  • NPI 1699041152

  Member Of

  NPD member

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256774400000",
    "number": "1457599722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT 4TH FLOOR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4521",
            "fax_number": "866-594-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N WASHINGTON ST",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352152",
            "telephone_number": "870-494-4022",
            "fax_number": "870-494-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HISTORIC DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-10-29",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "253-382-1919"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forrest City Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Henein Iskander, M.D.
• Dawn Herring, THERAPIST
• Madeline Kennedy Herrington, APRN-CNP
• Diane Hinton, THERAPIST
• Sarah Hirons
• Jamey Hobbs, RN
• Jennifer Leigh Hollis, LCSW
• Eva Hollowell, RN
• Deandre Holmes
• Samantha Holmes

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Forrest City, AR
• Providers in Forrest City, AR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; 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.