Provider Demographics
NPI:1548975873
Name:EPSILON KIDNEY CARE, PC
Entity type:Organization
Organization Name:EPSILON KIDNEY CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AWUA-LARBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-210-2550
Mailing Address - Street 1:PO BOX 33157
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0609
Mailing Address - Country:US
Mailing Address - Phone:888-867-9799
Mailing Address - Fax:833-841-0400
Practice Address - Street 1:4770 WOODMERE BLVD STE C4
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3083
Practice Address - Country:US
Practice Address - Phone:888-867-9799
Practice Address - Fax:833-841-0400
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EPSILON KIDNEY CARE, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty