Provider Demographics
NPI:1992733547
Name:CHALMETTE DIALYSIS CENTER
Entity type:Organization
Organization Name:CHALMETTE DIALYSIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MURAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HATIPOGLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-780-1422
Mailing Address - Street 1:4424 CONLIN ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2147
Mailing Address - Country:US
Mailing Address - Phone:594-780-1422
Mailing Address - Fax:504-780-1432
Practice Address - Street 1:4020 PARIS RD
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-1362
Practice Address - Country:US
Practice Address - Phone:504-780-1422
Practice Address - Fax:504-780-1432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA059261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA34497OtherBLUE CROSS BLUE SHIELD LA
LA1311138Medicaid
LA192515Medicare ID - Type Unspecified