Organization
ISD RENAL INC
Active
Other names
Blue River Valley Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
2309 S MILLER ST, STE 100, SHELBYVILLE, IN 46176-9350
(317) 398-0486
(317) 398-0493
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4514
(866) 594-9961
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
05
—
200827250D
—
IN
Enumeration date
05/26/2006
Last updated
12/31/2020
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