Organization
SNG - GREENVILLE DIALYSIS CENTER LP
Active
Organization
SNG - GREENVILLE DIALYSIS CENTER LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINAM C. MARTIN (CHIEF OPERATIONS OFFICER)
(817) 725-7900
Entity
Organization
Contact information
Practice address
4309 RIDGECREST RD, STE 100, GREENVILLE, TX 75402-6003
(903) 455-9911
(903) 455-9914
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 725-7900
(682) 207-1030
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110241
FACILITY LICENSE
TX
05
—
339807501
—
TX
Enumeration date
01/31/2014
Last updated
07/21/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up