Provider Demographics
NPI:1104803022
Name:DIALYNE COMPANY
Entity type:Organization
Organization Name:DIALYNE COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:330-743-2666
Mailing Address - Street 1:100 FEDERAL PLZ E
Mailing Address - Street 2:400 CITY CENTRE ONE
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44503-1810
Mailing Address - Country:US
Mailing Address - Phone:330-743-2666
Mailing Address - Fax:330-743-3456
Practice Address - Street 1:100 FEDERAL PLAZA E
Practice Address - Street 2:400 CITY CENTRE ONE
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44503-1810
Practice Address - Country:US
Practice Address - Phone:330-743-2666
Practice Address - Fax:330-743-3456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0954927Medicaid
OH0954927Medicaid