Provider Demographics
NPI:1306430947
Name:NORTH ALABAMA VASCULAR AND DIALYSIS ACCESS CARE LLC
Entity type:Organization
Organization Name:NORTH ALABAMA VASCULAR AND DIALYSIS ACCESS CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-949-3855
Mailing Address - Street 1:1 PARKWAY NORTH BLVD STE 200S
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2534
Mailing Address - Country:US
Mailing Address - Phone:847-949-3843
Mailing Address - Fax:877-823-7570
Practice Address - Street 1:1311 MEMORIAL PKWY NW STE 300
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5944
Practice Address - Country:US
Practice Address - Phone:256-535-5008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty