Organization
INDEPENDENT DIALYSIS GROUP NORTHEAST OHIO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN AMEDIA (PRESIDENT)
(330) 781-6212
Entity
Organization
Contact information
Practice address
48444 BELL SCHOOL RD STE 4, CALCUTTA, OH 43920-9646
(330) 781-6212
Mailing address
4822 MARKET ST STE 300, BOARDMAN, OH 44512-2122
(330) 781-6212
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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