| Organization Name: | SHINING STAR DIALYSIS INC |
| NPI Number: | 1063446912 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES K HILGER (VICE PRESIDENT) |
| Mailing Address: | 2180 Bradley Ave Neptune |
| State: | NJ US |
| Postal Code: | 077534427 |
| Phone Number: | 7327752725 |
| Fax Number: | 7327750500 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 03/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 22845 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |