Provider Demographics
NPI:1053355388
Name:THUMB AREA DIALYSIS CENTER
Entity type:Organization
Organization Name:THUMB AREA DIALYSIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-466-3272
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-0188
Mailing Address - Country:US
Mailing Address - Phone:989-466-3349
Mailing Address - Fax:989-466-7454
Practice Address - Street 1:6757 MAIN ST
Practice Address - Street 2:
Practice Address - City:CASS CITY
Practice Address - State:MI
Practice Address - Zip Code:48726-1556
Practice Address - Country:US
Practice Address - Phone:989-872-5544
Practice Address - Fax:989-872-5692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI40-4090623Medicaid
MI08982OtherBCBSM
MI09426OtherBCBSM
MI232573Medicare ID - Type Unspecified