Lifeline Renal Care LLC

Primary specialty

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

Legal business name

LIFELINE RENAL CARE LLC

Practice address

4309 Ridgecrest Rd Ste 100
Greenville, TX 75402-6003

Phone

(972) 859-9996

NPI assigned

Jun 13, 2024

Organization subpart

No

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

Authorized official

Name

Biju Kuriakose

Title

Ceo

Phone

(972) 859-9996

Specialties & licenses 1

Addresses

Tax ID family

Lifeline Renal Care LLC2 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.

• Lifelinerenalcare

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lewisville, TX
  • NPI 1750808374
  NPD tax ID

Locations

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1750124244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 SCOTTI ST",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750565882",
            "telephone_number": "972-859-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 RIDGECREST RD STE 100",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026003",
            "telephone_number": "972-859-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE RENAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "KURIAKOSE",
        "authorized_official_first_name": "BIJU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-859-9996"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wha Joon Lee, MD
• Legend Greenville Healthcare, LLC
• Pretei E Lemo, MBBS
• Erika Selene Lerma, NNP-BC
• Lifeline Dialysis LLC
• Norma Jean Linden, PH.D.
• Lisa a Fite MSN, Pmhnp-BC
• Live Well Pharmacy LLC
• Lone Star Premier Imaging, PLLC
• Austin Cole Love

• All providers in Greenville, TX
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.