| Organization Name: | KIDNEY INSTITUTE OF NORTH DAKOTA, LLC |
| NPI Number: | 1003809948 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KHALED RABADI (MEMBER) |
| Mailing Address: | 1451 - 44th Avenue South Suite 112-d Grand Forks |
| State: | ND US |
| Postal Code: | 582014055 |
| Phone Number: | 7017951300 |
| Fax Number: | 7017755200 |
| NPI Enumeration Date: | 08/25/2005 |
| NPI Last Update Date: | 07/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |