National Provider Identifier Database

DULUTH KIDNEY SERVICES LLC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

DULUTH KIDNEY SERVICES LLC
925 E SUPERIOR ST
SUITE 106
DULUTH, MN55802
Phone: 218-249-6230
Fax: 218-249-6231
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for DULUTH KIDNEY SERVICES LLC

NPI Number 1972552156
Legal business name
LBN
DULUTH KIDNEY SERVICES LLC
Authorized official SANDY POPHAM - (OWNER MD)
Entity Organization
Organization subpart No
Enumeration date 05/08/2006
Last updated 11/11/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • MN Medicaid: 462137900
  • Other: 9831014 MEDICA
  • MN Other: 04N86PO BLUE CROSS MN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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