Dialysis Organization Agreement Information Sheet
Exhibit 10.67
Dialysis Organization Agreement
Information Sheet
This Information Sheet sets forth certain definitions and other information as used in the attached Dialysis Organization Agreement. As used in such Dialysis Organization Agreement, the following terms shall have the meanings ascribed below:
DIALYSIS CENTER (FULL LEGAL NAME): |
TERRITORY: | United States |
TERM START DATE: | January 1, 2011 |
TERM END DATE: | June 30, 2011 |
PRODUCT INVOICE DISCOUNT PERCENTAGES:
PRODUCT: EPOGEN® (Epoetin alfa)
All products and packages generally made available for sale in the United States throughout the Term (as defined in Section 8.1). |
INVOICE DISCOUNT PERCENTAGE: [DELETED]% |
DIALYSIS CENTER NOTICE ADDRESS AND FAX:
000 Xxxxxx Xxxxxx
El Segundo, CA 90245
Fax: 000-000-0000
AMGEN AGREEMENT NO.: 920110141
[DELETED] = Portions of this exhibit are subject to a request for confidential treatment and have been redacted and filed separately with the Securities and Exchange Commission.
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Dialysis Organization Agreement
This Dialysis Organization Agreement (this “Agreement”) is made by and between Amgen USA Inc. (“Amgen”), a wholly-owned subsidiary of Amgen Inc., and DaVita Inc. (“Dialysis Center”) to set forth the terms and conditions upon which Dialysis Center shall purchase the Product and Amgen shall provide discounts and pay rebates on the Product. Amgen Inc. is a party to this Agreement for the purposes set forth in Sections 3.2, 4.6, 4.7, 6.1, 6.2, 7.1, 7.2.1, and 9.13 of this Agreement.
Amgen and Dialysis Center hereby agree as follows:
1. | DEFINITIONS |
When used with initial capitals herein, the following terms shall have the meanings ascribed to them below:
1.1. | “Affiliate” of a given entity shall mean an entity that controls, is controlled by, or under common control with such given entity. Control shall mean ownership of more than fifty percent (50%) of the voting stock of an entity or, for non-stock entities, the right to more than fifty percent (50%) of the profits of such entity. |
1.2. | “Authorized Wholesalers” shall mean those wholesalers listed on Exhibit B, as such list may be modified pursuant to Section 2.3. |
1.3. | “Data” shall have the meaning set forth in Schedule 1 of this Agreement. |
1.4. | “Designated Affiliates” shall mean any Affiliate of Dialysis Center listed on Exhibit C, as such list may be modified pursuant to Section 2.2. |
1.5. | “Designated Managed Centers” shall mean any Managed Center listed on Exhibit D as such list may be modified pursuant to Section 2.2. |
1.6. | “Dialysis Center Purchasers” shall mean Dialysis Center, its Designated Affiliates and Designated Managed Centers. |
1.7. | “ESRD” shall mean end stage renal disease. |
1.8. | “HIPAA” shall mean the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, each as may be amended. |
1.9. | “Individually Identifiable Health Information” shall have the meaning specified in HIPAA. |
1.10. | “Information Sheet” shall mean the information sheet attached hereto. |
1.11. | “Invoice Discount Percentage” shall mean, with respect to the Product, the percentage set forth as the “Invoice Discount Percentage” in the Information Sheet. |
1.12. | “Managed Center” shall mean a dialysis facility that is not an Affiliate of Dialysis Center but for which Dialysis Center or an Affiliate of Dialysis Center provides management and administrative services, including the purchase and billing of the Product. |
1.13. | “OutcomesPlus” shall mean Amgen’s proprietary, HIPAA compliant retrospective observational database that is comprised of the electronic de-identified patient-level data, set forth in Schedule 1. |
1.14. | “Qualified Gross Purchases” shall mean the amount of Product purchased by Dialysis Center Purchasers during the Term from an Authorized Wholesaler (or from Amgen pursuant to Section 2.3) and confirmed by Amgen through sales tracking data. Qualified Gross Purchases shall be calculated using the [DELETED] in effect at the time of the relevant purchase. |
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1.15. | “Quarter” shall mean each calendar quarter during the Term (i.e., January 1 through March 31 or April 1 through June 30). |
1.16. | “[DELETED]” shall mean the [DELETED] for the Product to [DELETED] as established by [DELETED] its [DELETED] from time to time, not including prompt pay or other discounts, rebates, or reductions in [DELETED]. |
2. | PURCHASE AND SALE OF PRODUCTS |
2.1. | Discounts. Effective on the Term Start Date of this Agreement, Dialysis Center Purchasers shall have the right to purchase the Product through Authorized Wholesalers or directly from Amgen pursuant to Section 2.3 at the then-prevailing [DELETED] less the Invoice Discount Percentage. Amgen reserves the right to change [DELETED] for the Product at any time, by any amount, without notice, subject in such case to the Special Price Rebate provisions set forth in Section 2.2 of Exhibit A. Amgen shall notify Dialysis Center of any change to [DELETED] in accordance with Amgen’s customary business practices. Pricing, discounts, and rebates set forth in this Agreement are without regard to any wholesaler markup, service fees, or other charges, which may be charged separately by Authorized Wholesalers. |
2.2. | Affiliates and Managed Centers. |
2.2.1. | Only purchases of Product made by Dialysis Center Purchasers shall be eligible for the pricing, discounts and/or rebates granted pursuant to this Agreement. Dialysis Center shall have the right to remove its Affiliates from the list of Designated Affiliates and to remove Managed Centers from the list of Designated Managed Centers by thirty (30) days prior written notice to Amgen. Dialysis Center shall have the right to add its Affiliates and Managed Centers to the list of Designated Affiliates or list of Designated Managed Centers, as applicable, with prior written notice to Amgen and upon Amgen’s approval, which shall not be unreasonably conditioned, withheld or delayed, it being understood that Dialysis Center shall use its commercially reasonable best efforts to provide Amgen and the applicable Authorized Wholesaler with at least thirty (30) days prior written notice in situations involving de novo dialysis facilities and at least fifteen (15) days prior written notice in the case of dialysis facilities that are acquired by Dialysis Center or that enter into management or administrative service agreements with Dialysis Center. In the event Dialysis Center provides fifteen (15) or fewer days prior written notice, Dialysis Center agrees to coordinate with Dialysis Center’s Authorized Wholesaler to ensure purchases made by such Affiliates and/or Managed Centers are credited to Dialysis Center upon the date Amgen adds such Affiliates and/or Managed Centers to the list of Designated Affiliates or list of Designated Managed Centers, as applicable. Amgen shall restrict the dissemination of information pertaining to the addition of Affiliates as Designated Affiliates and Managed Centers as Designated Managed Centers to its employees, agents and contractors that have a need to know such information. So long as Dialysis Center has used its commercially reasonable best efforts to provide such advance notice to Amgen, such new Affiliates and Managed Centers shall be added to the list of Designated Affiliates or list of Designated Managed Centers, as applicable, as of the date of acquisition by Dialysis Center or the commencement of the management relationship between Dialysis Center and Managed Center or such later date specified by Dialysis Center. |
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2.2.2. | All purchases of the Product made on and after the date such Affiliates and Managed Centers are added to the list of Designated Affiliates or list of Designated Managed Centers, as applicable, shall constitute “Qualified Gross Purchases” under this Agreement and shall be included for purposes of calculating each and every discount and rebate provided hereunder and in Exhibit A (which is incorporated by reference hereto and made a part of this Agreement), including the Invoice Discount Percentage. Amgen shall pay all discounts and rebates earned by Dialysis Center to Dialysis Center unless Amgen can demonstrate to Dialysis Center that it is obligated to pay any such discounts and/or rebates to any person or entity other than Dialysis Center. |
2.2.3. | In the event of a change to information set forth in the list of Designated Affiliates or list of Designated Managed Centers (such as address), Dialysis Center shall promptly notify Amgen and Amgen shall update the relevant list. Amgen shall reserve the right in its reasonable discretion to remove Affiliates from the list of Designated Affiliates and remove Managed Centers from the list of Designated Managed Centers in accordance with the following: termination of any Designated Affiliate or Designated Managed Center by Amgen shall be effective (a) immediately in instances in which Amgen determines, in its sole discretion, that such immediate termination is required by law or order of any court or regulatory agency or as a result of negligence or willful misconduct in the use or administration of the Product by such Designated Affiliate or Designated Managed Center; or (b) upon thirty (30) days prior written notice to Dialysis Center in all other instances; provided, however, that Dialysis Center shall have the right to object to the removal of a Designated Affiliate or Designated Managed Center other than if required by law or order of any court or regulatory agency, but must notify Amgen within five (5) business days of such objection, explaining the basis for such objection; and provided further, that such termination shall be effective before the expiration of such thirty (30) days where Dialysis Center requests or consents to such earlier termination. |
2.2.4. | Dialysis Center shall ensure compliance with the terms and conditions of this Agreement applying to Dialysis Center by its Designated Affiliates and Designated Managed Centers. Dialysis Center shall be liable for the acts and omissions of its Designated Affiliates and Designated Managed Centers, and Amgen shall have the right (but not the obligation) to proceed directly against Dialysis Center in the event of a breach of this Agreement by any such Designated Affiliate or Designated Managed Center, without first proceeding against such Designated Affiliate or Designated Managed Center. |
2.3. | Authorized Wholesalers. Only Product purchased from Authorized Wholesalers or directly from Amgen pursuant to this Section 2.3 shall be eligible for the pricing, discounts and/or rebates granted pursuant to this Agreement. Dialysis Center shall have the right to remove wholesalers from the list of Authorized Wholesalers by thirty (30) days prior written notice to Amgen, and shall have the right to add wholesalers to the list of Authorized Wholesalers by thirty (30) days notice to Amgen upon Xxxxx’s approval, which approval shall not be unreasonably withheld or delayed. Amgen shall have the right, in its reasonable discretion, to add wholesalers to the list of Authorized Wholesalers by thirty (30) days prior written notice to Dialysis Center. Amgen shall have the right, in its reasonable discretion, to remove wholesalers from the list of Authorized Wholesalers by thirty (30) days prior written notice to Dialysis Center, so long as (a) Amgen rejects or terminates such wholesaler with respect to providing the Product to |
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any and all purchasers of the Product, or (b) such wholesaler independently requests Amgen to remove it as an Authorized Wholesaler for Dialysis Center. In the event Amgen terminates any Authorized Wholesaler from which any Dialysis Center Purchasers are purchasing the Product, Amgen shall work with Dialysis Center to transition the Dialysis Center Purchasers purchasing to an Authorized Wholesaler and shall use reasonable efforts to establish a direct purchasing relationship in any interim period, which in no event shall exceed sixty (60) days, between the removal of the removed Authorized Wholesaler and the initiation of purchases from a new Authorized Wholesaler, if no alternative Authorized Wholesaler exists at such time. Any such direct purchasing relationship shall be subject to credit qualification and the approval by Amgen of an application for direct ship account. If Dialysis Center Purchasers purchase directly from Amgen as contemplated immediately above, all purchases made from Amgen shall be deemed “Qualified Gross Purchases” and all such purchases shall be eligible for all of the discounts and/or rebates provided for in this Agreement and Exhibit A. |
2.4. | Own Use. Dialysis Center hereby certifies that Product purchased hereunder shall be for Dialysis Center Purchasers’ “own use” for the treatment of dialysis patients. Only Product purchased for Dialysis Center Purchasers’ “own use” for the treatment of dialysis patients shall be eligible for the pricing, discounts and/or rebates available pursuant to this Agreement. Dialysis Center Purchasers covenant that they shall not seek any such pricing, discounts and/or rebates for any Product not for their “own use” for the treatment of dialysis patients, and shall promptly notify Amgen in the event Amgen does provide Dialysis Center Purchasers any such pricing, discount and/or rebates. |
2.5. | Product License Agreement. Amgen has publicly disclosed that it is a party to a product license agreement with Ortho Pharmaceutical Corporation. Amgen hereby represents to Dialysis Center that, under such product license agreement: (a) Amgen has the exclusive right to promote and sell Epoetin alfa, in the United States, under the trade name EPOGEN® for use with dialysis patients, (b) Amgen has licensed Ortho, as Amgen’s distributor, the exclusive right to promote and sell Epoetin alfa in the United States under the trade name PROCRIT® for non-dialysis uses only and (c) Ortho is not authorized to promote or sell PROCRIT® in the United States for dialysis use. Consistent with the terms of such product license agreement and so long as such agreement remains in effect, Dialysis Center Purchasers shall not use PROCRIT® for use with dialysis patients. |
2.6. | Vial Sizes. Dialysis Center agrees that Dialysis Center Purchasers shall maintain consistency in their relative mix of Product types in their purchases. Dialysis Center shall give Amgen at least three months’ prior written notice should the percentage of Dialysis Center Purchasers’ purchases made up by any particular SKU deviate by more than [DELETED] percent ([DELETED]%) from the previous Quarter unless Xxxxx’s prior written consent shall have been obtained. By way of example, if EPOGEN® 2,000 unit/mL (NDC 55513-126-01) made up [DELETED]% of the aggregate purchases of Product by Dialysis Center Purchasers in the first Quarter of given year, it shall make up no less than [DELETED]% (i.e. [DELETED]% of [DELETED]%) and no more than [DELETED]% (i.e. [DELETED]% of [DELETED]%) of the aggregate purchases of Product by Dialysis Center Purchasers in the second Quarter of such year, unless Dialysis Center shall have given Amgen three months’ prior written notice of such change. Dialysis Center shall promptly notify and consult with Amgen should it consider a material change to its Product type mix. Amgen shall use its commercially reasonable efforts to accommodate requests by Dialysis Center for Product in SKUs different from its typical mix if such Product is available for distribution and sale in the Territory and is not committed to others. |
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3. | REBATES |
3.1. | Earning and Vesting of Rebates. Dialysis Center shall qualify for rebates based upon verified Qualified Gross Purchases in accordance with the terms and conditions of this Agreement and the formulae set forth in Exhibit A. For the purposes of calculating any of the rebates hereunder, Qualified Gross Purchases shall be deemed made on the date of invoice to any Dialysis Center Purchaser from the Authorized Wholesaler or Amgen pursuant to Section 2.3. |
3.2. | Payment of Rebates. Rebates shall be paid Quarterly in arrears, within the time frame specified for each such rebate in Exhibit A, by electronic funds transfer (“EFT”) using EFT information provided to Amgen by Dialysis Center as necessary to enable EFT payment. Amgen Inc. hereby guarantees Amgen’s obligation to pay all rebates earned by Dialysis Center hereunder. All payments are subject to audit and final determination as provided in Section 3.3 hereto. |
3.3. | Verification and Audit. Rebates specified herein are subject to verification and audit of the relevant purchase and other data (including the Data supplied pursuant to Section 4), as reasonably necessary to calculate amounts payable hereunder. Dialysis Center Purchasers shall maintain their books and records in accordance with U.S. generally accepted accounting principles, consistently applied. To the extent either Amgen or Dialysis Center, in its reasonable discretion, determines that it is necessary to verify and confirm the calculation of any rebate described in this Agreement in order to audit and assure compliance with the terms of this Agreement, the requesting party shall provide written notice of same to the other party (an “Objection Notice”) setting forth in detail any and all items of disagreement related to such computation or statement. Amgen and Dialysis Center shall jointly engage (at the requesting party’s sole cost and expense, subject to any reimbursement by the other party as set forth below) and refer the items in dispute to a nationally recognized firm of independent, certified public accountants as to which Amgen and Dialysis Center mutually agree (the “Firm”), to resolve any disagreements. Amgen and Dialysis Center will direct the Firm to render a written determination within twenty (20) days of its retention, and Amgen and Dialysis Center and their respective agents will cooperate with the Firm during its engagement. Any such audit shall be conducted during normal business hours, and so as not to unreasonably interfere with the business of Amgen and/or any of the Dialysis Center Purchasers. In the event any such audit is requested by Amgen and shows that Dialysis Center Purchasers have submitted incorrect information resulting in Dialysis Center receiving in excess of [DELETED] percent ([DELETED]%) of the amount to which it was entitled in any Quarter, Dialysis Center shall reimburse Amgen for the reasonable costs of such audit; otherwise, Amgen shall be responsible for the costs of such audit. In the event any such audit is requested by Dialysis Center and shows that Dialysis Center Purchasers have submitted correct information but have been underpaid by more than [DELETED] percent ([DELETED]%) of the amount to which they were entitled in any Quarter, Amgen shall reimburse Dialysis Center for the reasonable costs of such audit; otherwise, Dialysis Center shall be responsible for the costs of such audit. The determination of the Firm will be conclusive and binding upon Amgen and Dialysis Center. Following any audit that shows any over or underpayment hereunder, the relevant party shall, within sixty (60) days, make payment to the other party for the difference between the amount paid hereunder and the amount actually payable hereunder based upon the results of such audit. |
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3.4. | Adjustments for Changes. In accordance with Section 2.2 above, in the event of an Affiliate’s addition to or deletion from the list of Designated Affiliates or a Managed Center’s addition to or deletion from the list of Designated Managed Centers during any Quarter of the Term, Amgen shall adjust Qualified Gross Purchases to account for such change by adding or deleting such Designated Affiliates’ or Designated Managed Centers’, as applicable, purchases to or from the relevant Quarter or comparison Quarter (or portion thereof). |
3.5. | Treatment of Discounts and Rebates. |
3.5.1. | Dialysis Center agrees that Dialysis Center Purchasers shall properly disclose and account for all discounts and/or rebates earned hereunder, in whatever form, in compliance with all applicable federal, state, and local laws and regulations, including §1128B(b) of the Social Security Act, as amended and its implementing regulations. Dialysis Center agrees that, if required by such statutes or regulations, it (together with its Designated Affiliates) shall and it shall cause its Designated Managed Centers to (i) claim the benefit of such discount and/or rebate received in the fiscal year in which such discount and/or rebate was earned or the year after, (ii) fully and accurately report the value of such discount and/or rebate in any cost reports filed under Title XVIII or Title XIX of the Social Security Act, as amended or a state health care program, and (iii) provide, upon request by the U.S. Department of Health and Human Services or a state agency or any other federally funded state health care program, the information furnished to Dialysis Center Purchasers by Amgen concerning the amount or value of such discount and/or rebate. |
3.5.2. | In order to assist Dialysis Center’s compliance with its obligations as set forth in Section 3.5.1 above, Amgen agrees that it will fully and accurately report all discounts and/or rebates on the invoices or statements submitted to Dialysis Center and use reasonable efforts to inform Dialysis Center of its obligations to report such discounts and/or rebates; or where the value of a discount and/or rebate is not known at the time of sale, Amgen shall fully and accurately report the existence of the discount and/or rebate program on the invoices or statements submitted to Dialysis Center, use reasonable efforts to inform Dialysis Center of its obligations to report such discounts and/or rebates and when the value of the discounts and/or rebates becomes known, provide Dialysis Center with documentation of the calculation of the discount and/or rebate identifying the specific goods or services purchased to which the discount and/or rebate will be applied, in accordance with Section 3.6 below. |
3.6. | Reports. Amgen shall provide to Dialysis Center a quarterly statement of the discounts and/or rebates earned hereunder with the itemization of Product purchases made in a particular Quarter, broken down for each Dialysis Center Purchaser and any other information that Dialysis Center may reasonably request that is reasonably available to Amgen and necessary for Dialysis Center to obtain in order to comply with its obligations hereunder. Dialysis Center agrees that it will provide such information to its Dialysis Center Purchasers in a timely manner in order to allow such Dialysis Center Purchasers to meet their reporting and other obligations hereunder and under applicable law and regulation. |
3.7. | Best Price Limitation. Dialysis Center and Amgen do not intend for any discount or rebate under this Agreement or aggregated price concessions to Dialysis Center to |
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result in the establishment of “Best Price” for any dosage, form or strength of the Product under the Medicaid Best Price Program (42 U.S.C. § 1396r-8) including all implementing regulations (“the Medicaid Best Price Program”). In the event transactions involving [DELETED] parties other than Dialysis Center result in Dialysis Center’s establishment of Best Price, Amgen may [DELETED] discounts or rebates under this Agreement. In all other events, Amgen shall have the right, in its sole discretion, to determine the extent to which any [DELETED] may impact Amgen’s Best Price calculation and in such instances, if Amgen believes any [DELETED] to Dialysis Center may establish “Best Price,” Amgen shall have the right to [DELETED] discounts and/or rebates, subject to the next sentence, [DELETED] and [DELETED], and shall promptly notify Dialysis Center of the [DELETED] rebate [DELETED]. Other than as provided for under Section 8.5, if Dialysis Center establishes “Best Price” for any dosage, form or strength of the Product under the Medicaid Best Price Program, then Amgen may only adjust discounts, rebates and other incentives to result in the [DELETED] available under this Agreement as described in this Agreement and in Exhibit A (i.e. the discount opportunity, as summarized in Section 4 of Exhibit A). Any [DELETED] of discounts and/or rebates shall be collected from Dialysis Center through the [DELETED] of discounts and rebates that Dialysis Center is entitled to [DELETED], as determined by Amgen. If the contract is terminated or expires prior to the full amount of [DELETED] rebates owed to Amgen being collected, Dialysis Center shall pay any remaining amounts to Amgen within thirty (30) days of contract termination or expiration. |
4. | PATIENT AND PRODUCT DATA |
4.1. | Data Submission. Subject to the requirements set forth elsewhere in this Agreement, including Exhibit A, Dialysis Center shall provide certain patient and product data, as specified on Schedule 1 (the “Data”) to Amgen (or to a data collection vendor specified and paid for by Amgen) on a calendar monthly basis by the last day of the following calendar month (or the next business day if such last day is not a business day). To the extent Amgen requests that Dialysis Center deliver the Data to a designated data collection vendor instead of Amgen directly, Dialysis Center’s delivery of the Data to such data collection vendor shall be considered delivery to Amgen for purposes of this Agreement. Data shall be submitted by Dialysis Center in the format set forth on Schedule 1. To the extent Amgen requests that Dialysis Center deliver the Data to a designated data collection vendor, Amgen agrees to cause any such designated data collection vendor to adhere to and be bound by all of the requirements relating to the confidentiality, use and disclosure of the Data hereunder as applicable to Amgen, and any failure by any such designated data collection vendor to act in accordance with such requirements shall be the sole responsibility of Amgen, and Amgen shall be directly liable to Dialysis Center as if Amgen had directly breached any of its obligations or the requirements related to the confidentiality, use or disclosure of the Data as set forth herein. |
4.2. | HIPAA Compliance. The parties acknowledge and agree that Dialysis Center has no intent to provide to Amgen (or any designated data collection vendor), and Amgen has no intent to receive from Dialysis Center, any Data in violation of the HIPAA Privacy Rule. Further, it is the intent of such parties that each delivery of the Data hereunder to Amgen (or such designee) meet the requirements for “statistical de-identification” as set forth in 45 C.F.R. Section 164.514(b)(1). Accordingly, and notwithstanding anything in this Agreement to the contrary, Amgen acknowledges and agrees that Dialysis Center shall not be obligated to submit any Data pursuant to this Agreement unless and until a Certification has been delivered to Dialysis Center for the submission of such Data and |
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the Certification Requirements (as defined in Section 4.3) therein have been satisfied. For purposes of the foregoing, “Certification” shall mean a written certification delivered to Dialysis Center by a statistician who is reasonably acceptable to Dialysis Center and Amgen who meets the requirements set forth in 45 C.F.R. Section 164.514(b)(1) (a “Statistician”), which Certification must conclude that, subject to any conditions, requirements or assumptions set forth therein, each delivery of the Data pursuant to this Agreement will meet the standards for “de-identification” under HIPAA. |
4.3. | Certification Requirements. Promptly following the date of execution of this Agreement by the parties, Dialysis Center will engage (at Amgen’s sole cost and expense) a Statistician to render a Certification to Dialysis Center. In connection with the delivery of the Certification the parties agree to use their reasonable best efforts to facilitate the delivery of such Certification in an expedited manner. In support of the foregoing and in acknowledgement that the delivery of the Data hereunder is contemplated to be an ongoing obligation of Dialysis Center, the parties agree to amend or supplement this Agreement from time to time to reflect those additional representations, warranties or covenants of the parties as are necessary to support any conditions, requirements or assumptions contained in such Certification (the “Certification Requirements”). During the Term and upon request from Dialysis Center (which request shall not be more frequently than twice per calendar year, if at all), Amgen agrees to certify to Dialysis Center in writing that the Certification Requirements have been fulfilled and that any representations or covenants of Amgen contained in this Agreement (or in any amendment or supplement hereto) in support of such Certification Requirements are true and correct or have been satisfied, as the case may be. Notwithstanding anything in this Agreement to the contrary, Amgen shall be under no obligation to pay any rebates pursuant to this Agreement, unless and until the initial Certification is issued. |
4.4. | Invalid Certification. |
4.4.1. | In the event that the Statistician determines that a Certification is no longer valid, the parties agree to use their reasonable best efforts to work together in good faith and take such actions as may be necessary to cause a valid Certification to be issued to Dialysis Center such that the delivery of the Data hereunder to Amgen may be resumed as quickly as possible, with the intent of preserving as many of the Data elements set forth in Schedule 1 as possible. |
4.4.2. | In the event that a change in applicable laws, rules or regulations is the cause for the Certification becoming invalid, each party shall have the right, after attempting to negotiate changes to this Agreement as contemplated above, to terminate this Agreement upon thirty (30) days written notice with no requirement that Dialysis Center deliver the Data and no right of Dialysis Center to receive the rebates set forth in Exhibit A. |
4.4.3. | In the event Dialysis Center is the cause of such Certification becoming invalid, Amgen shall have the right, after working together in good faith to take such actions as may be necessary to cause a valid Certification to be issued as contemplated above, to terminate this Agreement upon thirty (30) days prior written notice to Dialysis Center. In connection with any such termination, Amgen shall pay to Dialysis Center, in accordance with Exhibit A, the appropriate proportion of any rebates earned up to the dates covered in the last Data submission by Dialysis Center and thereafter Dialysis Center shall have no obligation to deliver any Data. |
4.4.4. | If Amgen is the cause of such Certification becoming invalid, Dialysis Center shall promptly notify Amgen of that fact and the parties shall work together in good faith to take such actions as may be necessary to cause a valid Certification to be issued as contemplated above. |
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4.4.5. | If a replacement Certification is not obtained within seventy five (75) days of the date that Dialysis Center sent the notice stating that the Certification was invalidated, either party may terminate this Agreement effective as of the ninetieth (90th) day after Dialysis Center transmitted the notice that the Certification was invalidated. |
4.4.6. | From the date Dialysis Center sends the notice to Amgen that the Certification was invalidated until the time that a new Certification is issued or the time that this Agreement is terminated, which period shall not exceed ninety (90) days from the date that Dialysis Center sent the notice of invalidation, Dialysis Center may suspend the delivery of the Data without losing the ability to earn rebates through the date this Agreement is terminated. To the extent the Data necessary for Amgen to calculate any rebate described in Exhibit A is not delivered as a result of a Certification becoming invalid, Dialysis Center shall calculate such rebates and shall provide the results of such calculations to Amgen until the delivery of the Data hereunder to Amgen can be resumed. In connection with the foregoing, Amgen shall be permitted to audit any such calculations made by Dialysis Center, either directly or through a third party selected by Amgen, subject to the execution and delivery of appropriate agreements regarding confidentiality and compliance with laws, including HIPAA. |
4.5. | Amgen Activities; Permitted Data Elements. Amgen represents, warrants, covenants and agrees that (i) absent the express written consent from Dialysis Center and other than linking with fields of information that contain only Permitted Data Elements (as defined below), Amgen will not link the Data with any other data elements; (ii) Amgen will delete, purge or eliminate from any database that will hold the Data, all data elements identified in the safe harbor at 45 C.F.R. Section 164.514(b)(2)(i), other than any data element that constitutes a Permitted Data Element; and (iii) Amgen will not create any reports that contain Patient Level Data (as defined below) or permit access to the Data by any person who otherwise has access to Patient Level Data for patients of Dialysis Center. For purposes of the foregoing and this Agreement, the following definitions shall apply: (A) “Patient Level Data” shall mean any data elements attributable to a particular patient; and (B) “Permitted Data Element” shall mean the data elements comprising the Data, together with any other data element that identifies dates of service (including admission dates and discharge dates), gender, age or ICD-9 diagnosis and procedure codes for any individual patient. Amgen represents, warrants, covenants and agrees that throughout the Term it will maintain and enforce such policies, standards or procedures, including those regarding various physical, technical and procedural safeguards, as necessary for Amgen to comply with the restrictions on use and disclosure of the Data by Amgen that are set forth herein. To the extent that Amgen desires to link with any data element not included in the list of Permitted Data Elements, Amgen shall so inform Dialysis Center in writing and identify the additional data elements desired to be included as a Permitted Data Element hereunder. Upon receipt of such notice, Dialysis Center will promptly engage, at Xxxxx’s expense, a Statistician to render a written Certification to Dialysis Center with respect to the Data, taking into account the desired linking of the additional data to be included as a Permitted Data Element hereunder. In connection with the foregoing, such Statistician shall provide a timeline to both Dialysis Center and Amgen setting forth the required time and any additional information necessary for such Statistician to conduct an appropriate review of |
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such new desired Permitted Data Elements, and inform the parties whether a Certification can be rendered within thirty (30) days. To the extent that such Statistician determines that such Certification cannot be rendered within such thirty (30) day time period, Dialysis Center and Amgen shall work together in good faith to identify a mutually acceptable alternate solution. |
4.6. | Data Use. Amgen and Amgen Inc. covenant and agree that Amgen shall only be permitted to use the Data as follows: (i) verification of the rebates referenced in this Agreement; (ii) [DELETED] and [DELETED] concerning [DELETED] of the Product; development of [DELETED] for the Product; (iii) running internal trending and forecasting analyses; (iv) development of [DELETED] materials for patients and [DELETED]; preparing and running OutcomesPlus reports; and (v) sales force targeting and compensation with respect to the Product. In addition, Amgen may use the Data, with the prior written consent of Dialysis Center (which shall not be unreasonably withheld), in support of any [DELETED] or [DELETED] issues related to the treatment of patients with renal disease or the dialysis business generally. Except as set forth above, Amgen and Amgen Inc. covenant that Amgen shall not otherwise use, disclose, sell or resell the Data, or the results of any analyses or any derivative works based in whole or part on any Data, without the prior written consent of Dialysis Center. Notwithstanding anything in this Agreement to the contrary, Amgen agrees to not use any Data (or the results of any analyses or any derivative works based in whole or part on any Data) in a manner that shows the Data separately or specifies that it came from any Dialysis Center Purchasers; provided however, that so long as the Data does not (a) constitute more than [DELETED] percent ([DELETED]%) of the overall data displayed for purposes of [DELETED] or [DELETED] of any [DELETED] of Dialysis Center; and (b) reasonably result in a [DELETED] to Dialysis Center, as determined by Dialysis Center in its reasonable discretion, then Amgen shall be permitted to use the Data (or the results of any analyses or any derivative works based in whole or part on any Data) for such purpose. |
4.7. | Patient ID. The “Patient ID” as described in the Data to be delivered hereunder shall be a consistent and unique alpha-numeric code (which shall not be derived from Individually Identifiable Health Information) and a “case identifier” to track the care rendered to each individual patient over time, and Amgen and Amgen Inc. covenant that Amgen shall not request and Dialysis Center shall not provide the key or list matching patient identities to these “Patient IDs” or unique case identifiers. |
4.8. | Clinical Research Studies. Dialysis Center and Amgen acknowledge that Dialysis Center, either directly or through DaVita Clinical Research, Inc. (“DCR”), an Affiliate of Dialysis Center, may from time to time be engaged in research studies in which patients of Dialysis Center Purchasers, may serve as clinical trial subjects (a “Research Study”). Notwithstanding any obligation of Dialysis Center in this Agreement to the contrary, including any requirement in Section 3.4 of Exhibit A, Dialysis Center shall not be required to submit Data for any patients of Dialysis Center Purchasers that are participating in a Research Study (a “[DELETED]”), but shall continue without limitation to be eligible for, and if earned receive, all rebates granted pursuant to this Agreement, so long as (i) Dialysis Center notifies Amgen of the [DELETED] of [DELETED] whose Data will not be delivered by Dialysis Center to Amgen as otherwise required by this Agreement as a result of such patient being a [DELETED], and (ii) the [DELETED] of [DELETED] whose Data is excluded by Xxxxxxxx Center does not exceed the [DELETED]. For purposes of the foregoing, “[DELETED]” means [DELETED] ([DELETED]) of the aggregate number of persons receiving treatment from Dialysis Center Purchasers in any calendar month. |
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5. | COMPENSATION DATA |
Dialysis Center agrees that it shall provide the data, with respect to the Product, set forth on Schedule 2 attached hereto (the “Compensation Data”) to Amgen in the electronic format set forth on Schedule 2 on a calendar [DELETED] basis no later than the fourteenth (14th) day of the following calendar [DELETED] following the [DELETED] for which such Compensation Data is being provided. Amgen acknowledges, agrees and covenants that it shall only use the Compensation Data for sales force targeting and compensation. Dialysis Center and Amgen acknowledge and agree that the Compensation Data does not include and shall never include any Individually Identifiable Health Information of any patient of Dialysis Center Purchasers. Notwithstanding the foregoing, Amgen acknowledges and agrees that Dialysis Center shall only be required to deliver the Compensation Data to Amgen for as long as [DELETED] Amgen shall indemnify, defend and hold harmless Dialysis Center from and against any and all loss, damage and/or expense (including reasonable attorney’s fees) that it may suffer as a result of claims, demands, actions, proceedings, liabilities, costs or judgments, or threats thereof arising out Dialysis Center’s supply of the Compensation Data to Amgen.
6. | WARRANTIES, REPRESENTATIONS AND COVENANTS |
6.1. | Power and Authority. Each party represents and warrants to the other that this Agreement: (a) has been duly authorized, executed, and delivered by it, (b) constitutes a valid, legal, and binding agreement enforceable against it in accordance with the terms contained herein, and (c) does not conflict with or violate any of its other contractual obligations, expressed or implied, to which it is a party or by which it may be bound. The party executing this Agreement on behalf of Dialysis Center specifically warrants and represents to Amgen that it is authorized to execute this Agreement on behalf of and has the power to bind the Dialysis Center Purchasers to the terms set forth in this Agreement. The parties executing this Agreement on behalf of Amgen and Amgen Inc. specifically warrant and represent to Dialysis Center that they are authorized to execute this Agreement on behalf of and have the power to bind Amgen and Amgen Inc. to the terms set forth in this Agreement. |
6.2. | Compliance with Law and Regulation. Amgen and Amgen Inc. shall, and Dialysis Center shall, comply with all applicable laws and regulations. Both parties represent and warrant the following (which representations and warranties shall be ongoing representations and warranties during the Term), and each party shall promptly notify the other party of any known change in status in respect to the following: (i) that it is not currently named on any of the following lists (A) HHS/OIG List of Excluded Individuals/Entities, (B) GSA List of Parties Excluded from Federal Programs, or (C) OFAC “SDN and Blocked Individuals”; and (ii) that if during the Term there is a change in either party’s status which excludes it from participation in any Federal health care program, the other party may terminate this Agreement immediately upon prior written notice to the other party. |
6.3. | Product. Amgen covenants and agrees that the Product is not and will not be adulterated or misbranded within the meaning of the Federal Food, Drug and Cosmetic Act, as amended, or within the meaning of any applicable state or municipal law, or is or will be a product which may not be introduced in to interstate commerce. Amgen warrants that the Product purchased pursuant to this Agreement (a) is manufactured, |
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and up to the time of its receipt by Authorized Wholesalers is handled, stored and transported in accordance with all applicable federal, state and local laws and implementing regulations, and meet all specifications for effectiveness and reliability as required by the United States Food and Drug Administration (the “FDA”), and (b) when used in accordance with the directions in the labeling is fit for the purposes and indications described in the labeling. Amgen warrants that the use of the Product by Dialysis Center Purchasers shall not infringe upon any ownership rights of any other person or upon any patent, copyright, trademark or other intellectual property or proprietary right or trade secret of any third party. Amgen agrees that as soon as practicable it will notify Dialysis Center of any material defect in the Product delivered to any Dialysis Center Purchasers in accordance with applicable law. |
7. | INDEMNITY AND INSURANCE |
7.1. | Insurance. Each of the parties agrees that it shall secure and maintain in full force and effect throughout the Term (and following termination, to the extent necessary to cover any claims arising from this Agreement) general liability insurance and product liability insurance (in the case of Amgen) each with limits of $5,000,000 each claim and in the aggregate including contractual liability coverage and workers’ compensation coverage in accordance with statutory requirements. Dialysis Center shall carry professional liability insurance with limits of $5,000,000 for each claim and in the aggregate. Any limits on either party’s insurance coverage shall not be construed to create a limit on such party’s liability with respect to its obligations under this Agreement. Each of the parties shall be named as an additional insured in each of the other’s general and product liability insurance policy or policies, except that Dialysis Center shall not be obligated to name Amgen as an additional insured under its professional liability coverage. To the extent practicable, such policies shall provide at least thirty (30) days prior written notice to the other party of the cancellation, non renewal or substantial modification thereof. Each of the parties shall supply certificates of insurance to the other party upon request, stating that insurer shall endeavor to provide at least thirty (30) days prior written notice to the other party of the cancellation thereof. Amgen Inc. hereby guarantees the performance of Xxxxx’s obligations as set forth in this Section 7.1. Each of the parties shall have the right to satisfy its obligations under this Section 7.1 through self-insurance. |
7.2. | Indemnity. |
7.2.1. | By Amgen. Amgen agrees to indemnify, defend, and hold Dialysis Center, its officers, directors, agents and employees (collectively, the “Dialysis Center Indemnitees”) harmless from and against any and all loss, damage and/or expense (including reasonable attorney’s fees) that they may suffer as a result of claims, demands, actions, proceedings, liabilities, costs or judgments, or threats thereof arising out of (i) any defect in the design or manufacture of the Product or handling by Amgen of the Product, including claims for property damage, loss of life, and bodily injury; or (ii) the breach by Amgen or Amgen Inc. of any of their respective warranties, representations or covenants contained in this Agreement. This indemnity is conditioned on Dialysis Center notifying Amgen of any claims falling within this indemnity within fifteen (15) business days after Dialysis Center receives notice of such claim. Notwithstanding anything to the contrary contained herein, Amgen and Amgen Inc. shall not have any obligation to defend, indemnify or hold the Dialysis Center Indemnitees harmless from claims, suits or damages, arising out of the negligent acts or omissions or willful misconduct of the Dialysis Center Indemnitees. Amgen Inc. hereby guarantees the performance of Xxxxx’s obligations as set forth in this Section 7.2.1. This indemnification shall survive the termination or expiration of this Agreement. |
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7.2.2. | By Dialysis Center. Dialysis Center agrees to indemnify, defend, and hold Amgen, its officers, directors, agents and employees (collectively, the “Amgen Indemnitees”) harmless from and against any and all loss, damage, and/or expense (including reasonable attorney’s fees) that they may suffer as a result of claims, demands, actions, proceedings, liabilities, costs or judgments, or threats thereof arising out of (i) Xxxxxxxx Center’s negligence or misconduct in the “administration” of the Product to its patients; or (ii) the breach by Dialysis Center of any of its warranties, representations or covenants contained in this Agreement. For purposes of the foregoing, the “administration” of the Product by Dialysis Center shall mean the dispensing and handling by Dialysis Center and its employees of such Product and the actual administration of such Product to patients by Dialysis Center and its employees, but shall exclude physician prescriptions of such Product to patients. This indemnity is conditioned on Amgen notifying Dialysis Center of any claims falling within this indemnity within fifteen (15) business days after Amgen receives notice of such claim. Notwithstanding anything to the contrary contained herein, Dialysis Center shall not have any obligation to defend, indemnify or hold the Amgen Indemnitees harmless from claims, suits or damages, arising out of the negligent acts or omissions or willful misconduct of the Amgen Indemnitees. This indemnification shall survive the termination or expiration of this Agreement. |
8. | TERM AND TERMINATION |
8.1. | Term. This Agreement shall come into effect as of the Term Start Date and shall expire as of the Term End Date (the “Term”), unless sooner terminated in accordance with this Section 8. |
8.2. | Termination for Breach. In addition to any other legal or equitable remedies which may be available to either party upon breach by the other party (other than Section 9.17), the non-breaching party may terminate this Agreement for a material breach upon thirty (30) days advance written notice specifying the breach, provided that such breach remains uncured at the end of the thirty (30) day period, or, where a cure cannot be completed within thirty (30) days, the breaching party has not materially commenced in good faith to effectuate a cure within such thirty (30) day period. In addition, in the event that Dialysis Center materially breaches any provision of this Agreement, and such breach remains uncured for thirty (30) days following written notice by Amgen specifying the breach, or where a cure cannot be completed within thirty (30) days and Dialysis Center has not materially commenced in good faith to effectuate such cure within such thirty (30) day period, Amgen shall have no obligation to continue to offer the terms described herein or pay any further discounts and/or rebates to Dialysis Center, except those discounts and/or rebates earned by Dialysis Center Purchasers up to the time of a breach which results in termination |
8.3. | Termination for Denying Access to Designated Affiliates and/or Designated Managed Centers. In the event of a breach by either party of the terms and conditions of Section 9.17, the non-breaching party may terminate this Agreement for a breach upon ten (10) days advance written notice specifying the breach, provided that such breach remains uncured at the end of such ten (10) day period, or, where a cure cannot be completed within such ten (10) day period, and the breaching party has not commenced in good faith to effectuate a cure within such ten (10) day period. |
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8.4. | Termination for Convenience. Either party shall have the right to terminate this Agreement in its entirety, including any discount, rebate or incentive program by thirty (30) days prior written notice to the other party. |
8.5. | Compliance with or Change in Law or Regulation. Notwithstanding anything contained herein to the contrary, in order to assure compliance with any existing federal, state or local statute, regulation or ordinance, or at any time following the enactment of any federal, state, or local law, regulation, policy, program memorandum or other interpretation, modification or utilization guideline by any payer that in any material manner reforms, modifies, alters, restricts, or otherwise materially affects the pricing of or reimbursement available for the Product, including the enactment of any reimbursement rule, guideline, final program memorandum, coverage decision, pricing decision, instruction or the like by the Centers for Medicare and Medicaid Services or one of its contractors (carriers or fiscal intermediaries), or any change in reimbursement systems that in any material manner reforms, modifies, alters, restricts or otherwise materially affects the reimbursement available to Dialysis Center for the Product, upon thirty (30) days prior written notice, (i) either party may terminate this Agreement, (ii) Amgen may, in its sole discretion, modify any pricing, rebate or discount terms contained herein, or (iii) Amgen may, in its sole discretion, exclude any Dialysis Center Purchasers from participating in this Agreement. Additionally, to assure compliance with any existing federal, state or local statute, regulation or ordinance, Amgen reserves the right, in its sole discretion, to exclude any Dialysis Center Purchasers from the pricing, rebate and discount provisions of this Agreement and/or to reasonably modify any pricing, rebate or discount terms contained herein. In the event either party has provided the other party a thirty (30) day notice as described in this Section 8.5, the parties agree to meet and, in good faith, negotiate a new agreement or amendment to this Agreement. Any such negotiations shall in no way toll or otherwise impact either party’s rights under this Section 8.5. |
8.6. | Effect of Termination. Upon any termination or expiration of this Agreement, any earned and vested rebates shall be paid in accordance with the terms set forth in Section 3. Upon termination of this Agreement for any reason other than actual or threatened breach by Dialysis Center, any earned but unvested rebates shall vest as of the effective date of such termination. In the event of any termination during a Quarter, Amgen shall pro-rate any data used in calculating payments hereunder, and such payments, as appropriate. |
8.7. | Survival. Sections 7 and 9 shall survive any expiration or termination of this Agreement. Sections 3.2 – 3.5, Sections 4 and 8.6 shall survive with respect to periods prior to such expiration or termination. |
9. | MISCELLANEOUS |
9.1. | Amendment. Except as expressly set forth herein, no amendment of this Agreement shall be effective unless expressed in a writing signed by a duly authorized representative of each party. |
9.2. | Assignment. Neither party may assign this Agreement to a third party without the prior written consent of the other party, which consent may not be unreasonably withheld, conditioned, or delayed. |
9.3. | Conflicting Provisions. To the extent that any provisions of Amgen’s general or customary policies and procedures or any terms of any purchase order conflict with or are in addition to the terms of this Agreement or any Exhibit or Schedule attached hereto, the terms of this Agreement and its Exhibits and Schedules shall govern. |
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9.4. | Construction. This Agreement shall be deemed to have been jointly drafted by the parties, and no rule of strict construction shall apply against either party. As used herein, the word “including” shall mean “including, without limitation.” |
9.5. | Counterparts; Facsimile/PDF Signatures. This Agreement may be executed in one or more counterparts, each of which shall be considered an original. The parties hereto agree that facsimile or PDF transmission of original signatures shall constitute and be accepted as original signatures. |
9.6. | Currency. All amounts herein are set forth in United States Dollars. |
9.7. | Force Majeure. Neither party will be liable for delays in performance or nonperformance of this Agreement or any covenant contained herein if such delay or nonperformance is a result of Acts of God, civil or military authority, civil disobedience, epidemics, war, failure of carriers to furnish transportation, strike, lockout or other labor disturbances, inability to obtain material or equipment, or any other cause of like or different nature beyond the control of such party. In the event there is a disruption or shortage in supply of the Product, Amgen will use commercially reasonable efforts to notify Authorized Wholesalers of such disruption in a time period and manner that is consistent with Amgen’s notification to other wholesalers of the Product. |
9.8. | Further Assurances. Each party shall perform all further acts reasonably requested by the other to effectuate the purposes of this Agreement, including obtaining the certifications under Section 4 or obtaining purchase data necessary from third parties to calculate any amounts payable pursuant to Exhibit A. |
9.9. | Governing Law. This Agreement shall be governed by the laws of the State of California (without regard to its conflict of law rules) and, except as otherwise set forth in this Agreement, the parties submit to the jurisdiction of the California courts, both state and federal. |
9.10. | Merger. This Agreement, together with the Information Sheet, the Schedules, and the Exhibits constitutes the entire agreement, written or oral, of the parties as of the Term Start Date concerning the subject matter hereof. |
9.11. | No Partnership. The relationship between Amgen and Dialysis Center is that of independent contractors, and not a partnership or an agency, franchise or other relationship. Neither party shall have the authority to bind the other. |
9.12. | Notices. Any notice or other communication required or permitted hereunder (excluding purchase orders) shall be in writing and shall be deemed given or made five (5) days after deposit in the United States mail with proper postage for first-class registered or certified mail prepaid, return receipt requested, or when delivered personally or by facsimile (as shown by concurrent written transmission confirmation and confirmed by overnight mail), or one (1) day following traceable delivery to a nationally recognized overnight delivery service with instructions for overnight delivery, in each case addressed to the address set forth below, or at such designated address that either party shall have furnished to the other in accordance with this Section 9.12: |
If to Amgen: | ||
Amgen USA Inc. | ||
One Amgen Center Drive, M/S 27-4-A | ||
Thousand Oaks, CA 91320-1789 | ||
Attn: Specialist, Contracts & Pricing – Nephrology Business Unit | ||
Fax: (000) 000-0000 |
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with a copy to : | ||
Amgen USA Inc. | ||
One Amgen Center Drive, M/S 38-5-A | ||
Thousand Oaks, CA 91320-1789 | ||
Attn: General Counsel | ||
Fax: (000) 000-0000 | ||
If to Amgen Inc.: | Amgen Inc. | |
One Amgen Center Drive, M/S 38-5-A | ||
Thousand Oaks, CA 91320-1789 | ||
Attn: General Counsel | ||
Fax No.: (000) 000-0000 | ||
If to Dialysis Center: | ||
0000 Xxx Xxxxxxxx Xxxxxxx, Xxxxx 000 | ||
Burlingame, California 94010 | ||
Attn: Vice-President of Purchasing | ||
Fax No.: (000) 000-0000 | ||
with a copy to: | ||
000 Xxxxxx Xxxxxx | ||
El Segundo, CA 90245 | ||
Attn: General Counsel | ||
Fax No.: (000) 000-0000 |
9.13. | Confidentiality. By the nature, terms and performance of this Agreement, Amgen and Dialysis Center acknowledge and agree that the parties will exchange confidential and proprietary information (including business and clinical practices and protocols and patient information) (collectively, “Confidential Information”). Confidential Information includes not only written information but also information transferred orally, visually, electronically, in a machine readable format or by any other means and includes all notes, analyses, compilations, studies and summaries thereof containing or based on, in whole or in part, any Confidential Information. Confidential Information does not include any information which the receiving party can show was publicly available prior to the receipt of such information by the receiving party, or thereafter became publicly available other than by any breach of this Agreement by the receiving party, additionally, for Dialysis Center only, Confidential Information does not include the Data or the Compensation Data. Information shall be deemed “publicly available” if it is a matter of public knowledge or is contained in materials available to the public. Accordingly, the parties agree (a) to hold all such Confidential Information (including the terms of this Agreement) received from the other in confidence and to use such Confidential Information solely for the purposes set forth in this Agreement; and (b) to not disclose any such Confidential Information received from the other, or the terms of this Agreement, to any third party (including Amgen Inc. or any other affiliate of Amgen), or otherwise make such information public without prior written authorization of the other |
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party, except where such disclosure is contemplated hereunder or required by law or pursuant to subpoena or court or administrative order, and then only upon prior written notification to the other party (giving such party an adequate opportunity to take whatever steps it deems necessary to prevent, limit the scope of or contest the disclosure). Any party which seeks to prevent disclosure or to contest or limit the scope of any such disclosure by the other party shall pay all of the costs and expenses incurred by the other party directly related thereto, and such other party shall not unreasonably object to or interfere with the objecting party’s actions it deems necessary to undertake. For purposes of the foregoing, any Confidential Information received by any employee, partner, agent, affiliate, consultant, advisor, data collection vendor or other representative (a “Representative”) of a party to this Agreement pursuant to the terms of this Agreement shall be deemed received by such party to this Agreement, and any breach by any such Representative of the foregoing confidentiality provisions shall be deemed a breach by the respective party to this Agreement. |
9.14. | Severability. Subject to the provisions of Section 8.5, should any one or more of the provisions of this Agreement be determined to be illegal or unenforceable, the parties shall attempt, in good faith, to negotiate a modification of this Agreement so as to comply with the relevant law or regulation. Should they be unable to do so within thirty (30) days, either party shall have the right to terminate this Agreement upon ten (10) days prior written notice to the other. |
9.15. | Waiver. No party shall be deemed to have waived any right hereunder, unless such waiver is expressed in a writing signed by such party. |
9.16. | Open Records. To the extent required by §1861(v)(1)(I) of the Social Security Act, as amended, the parties will allow the U.S. Department of Health and Human Services, the U.S. Comptroller General and their duly authorized representatives, access to this Agreement and all books, documents and records necessary to certify the nature and extent of costs incurred pursuant to it during the Term and for four (4) years following the last date any Product or services are furnished under it. If Amgen carries out the duties of this Agreement through a subcontract worth $10,000 or more over a 12-month period with a related organization, the subcontract shall also contain an access clause to permit access by the U.S. Department of Health and Human Services, the U.S. Comptroller General, and their duly authorized representatives to the related organization’s books and records. |
9.17. | [DELETED] to [XXXXXXX] and [DELETED]. Amgen’s sales representatives shall be [DELETED] during [DELETED] to [DELETED] and/or [DELETED] for the [DELETED] of [DELETED] and providing [DELETED] regarding the [DELETED] and [DELETED] ([DELETED]) in accordance with each [DELETED] information. Amgen covenants and agrees that neither it nor any of its sales representatives shall have access to any Individually Identifiable Health Information while [DELETED] any [DELETED] and/or [DELETED]. Amgen acknowledges and agrees that (i) all of Dialysis Center’s applicable vendor relations policies and procedures and any updates thereto (the “Policies and Procedures”) that will be in effect during the Term are and will be available for viewing by Amgen and its sales representatives during the Term at xxxx://xxx.xxxxxx.xxx/xxxxx/xxxxxxx/?xxx0000 and (ii) Amgen and its sales representatives shall abide by all such Policies and Procedures during the Term to the extent that such Policies and Procedures have not changed since the Term Start Date in a manner that would limit Amgen’s rights under this Section 9.17. The parties acknowledge and agree that all educational, marketing and/or promotional materials with respect to the [DELETED] and [DELETED] delivered by Amgen to Dialysis Center prior |
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to the Term Start Date are approved (the “Initial Materials”). Amgen has delivered a true and correct copy of the Initial Materials listed in Schedule 3 to Dialysis Center prior to the Term Start Date. Amgen covenants and agrees that any changes, modifications and/or supplements to the Initial Materials and/or any new educational, marketing and/or promotional materials and/or presentations with respect to the [DELETED] and/or [DELETED] must be approved by DCR, which approval may only be given in writing by DCR’s Vice President of Clinical Research or his authorized representative. DCR’s Vice President of Clinical Research or his authorized representative agrees to notify Amgen of his decision within ten (10) business days following receipt of such request; otherwise, such request will be deemed denied. |
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The parties have executed this Agreement by their designated representatives set forth below.
AMGEN USA INC. | DIALYSIS CENTER | |||||||
By: | /s/ Xxxx Xxxxxxxx |
By: | /s/ Xxxxxx Xxxxx | |||||
Name (print): | Xxxx Xxxxxxxx |
Name (print): | Xxxxxx Xxxxx | |||||
Title: | Executive Director, Contracts & Pricing |
Title: | Chief Operating Officer | |||||
Date: | 12/17/2010 |
Date: | 12/17/2010 |
Amgen Inc. with respect to certain provisions of this Agreement as set forth herein.
Amgen Inc. | ||
By: | /s/ Xxxx Xxxxxxxx | |
Name (print): | Xxxx Xxxxxxxx | |
Title: | Executive Director, Pricing | |
Date: | 12/17/2010 |
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Exhibit A
Discount Terms and Conditions
1 | DEFINITIONS. In addition to the defined terms set forth in Section 1 of this Agreement, the following terms, as used in this Exhibit A, shall have the meaning ascribed below. |
Special Price Rebate Definitions
1.1 | “[DELETED]” shall mean, at any date of determination, [DELETED] as of such date. |
1.2 | “Discounts” shall mean all rebates and discounts set forth in this Agreement that may be earned by the Dialysis Center Purchasers pursuant to the terms and conditions set forth in this Agreement, which shall be earned, calculated and vested as provided in this Agreement. |
1.3 | “[DELETED]” shall mean [DELETED] percent ([DELETED]%) [DELETED] as of December 8, 2010, which is $[DELETED] per [DELETED] units of EPOGEN, or $[DELETED]. |
1.4 | “Special Price Rebate” shall mean the rebate described in Section 3.2 of this Exhibit A. |
1.5 | “Special Price Rebate Percentage” shall mean, at any date of determination, a percentage (rounded to two decimal places) to calculate any Special Price Rebate to be paid to Dialysis Center on account of [DELETED] increase for the Quarter during which such [DELETED] occurs, which Special Price Rebate Percentage shall equal: |
A - B * C
A
Where
“A” equals [DELETED]
“B” equals [DELETED]
“C” equals [DELETED] ([DELETED]) minus the Discounts earned by Dialysis Center Purchasers during such Quarter, expressed as a percentage of Qualified Gross Purchases
For example, if [DELETED] is $[DELETED], [DELETED] is $[DELETED] and the Discounts earned during the applicable Quarter are [DELETED]% of Qualified Gross Purchases for such Quarter, the Special Price Rebate Percentage would be calculated as follows:
Special Price Rebate Percentage Illustration: |
[DELETED] – [DELETED] * ([DELETED] – Discount %) [DELETED]
or
$[DELETED] - $[DELETED] * ([DELETED] - [DELETED]) = [DELETED]% $[DELETED] |
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Quality Rebate Definitions
1.6 | “Aggregate Greater Than [DELETED] Baseline Performance” shall mean [DELETED]% for the period of January 1, 2011 through March 31, 2011 and [DELETED]% for the period of April 1, 2011 through June 30, 2011. |
1.7 | “Aggregate Greater Than [DELETED] Percentage” shall mean for any Quarter during the Term, the percentage of Dialysis Center Purchasers’ patients with hemoglobin values greater than [DELETED] g/dL calculated as set forth in Section 3.3.3 of this Exhibit A. |
1.8 | “Aggregate Less Than [DELETED] Baseline Performance” shall mean [DELETED]% for the period of January 1, 2011 through March 31, 2011 and [DELETED]% for the period of April 1, 2011 through June 30, 2011. |
1.9 | “Aggregate Less Than [DELETED] Percentage” shall mean for any Quarter during the Term, the percentage of Dialysis Center Purchasers’ patients with hemoglobin values less than [DELETED] g/dL calculated as set forth in Section 3.3.4 of this Exhibit A. |
1.10 | “Greater Than [DELETED] Requirement Rebate Score” shall mean for any Quarter in calendar year 2011, the “Earned Rebate Score” (as designated in the Greater Than [DELETED] Requirement Rebate Score Table below) multiplied by [DELETED] ([DELETED]). The Earned Rebate Score shall be determined by calculating the difference between (A) the Aggregate Greater than [DELETED] Percentage for such Quarter and (B) Aggregate Greater Than [DELETED] Baseline Performance. |
Greater Than [DELETED] Requirement Rebate Score Table | ||
Aggregate Greater Than [DELETED] Percentage minus Aggregate Greater Than [DELETED] Baseline Performance |
Earned Rebate Score | |
[DELETED]% and below |
[DELETED] | |
[DELETED]% - [DELETED]% |
[DELETED] | |
[DELETED]% - [DELETED]% |
[DELETED] | |
[DELETED]% - [DELETED]% |
[DELETED] | |
[DELETED]% - [DELETED]% |
[DELETED] | |
[DELETED]% and above |
[DELETED] |
1.11 | “Less Than [DELETED] Requirement Rebate Score” shall mean for any Quarter in calendar year 2011, the “Earned Rebate Score” (as designated in the Less Than [DELETED] Requirement Rebate Score Table below) multiplied by [DELETED] ([DELETED]). The Earned Rebate Score shall be determined by calculating the difference between (A) the Aggregate Less than [DELETED] Percentage for such Quarter and (B) the Aggregate Less Than [DELETED] Baseline Performance. |
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Less Than [DELETED] Requirement Rebate Score Table | ||
Aggregate Less Than [DELETED] Percentage minus Aggregate Less Than [DELETED] Baseline Performance |
Earned Rebate Score | |
[DELETED]% and below |
[DELETED] | |
[DELETED]% - [DELETED]% |
[DELETED] | |
[DELETED]% - [DELETED]% |
[DELETED] | |
[DELETED]%- [DELETED]% |
[DELETED] | |
[DELETED]% - [DELETED]% |
[DELETED] | |
[DELETED]% and above |
[DELETED] |
1.12 | “Quality Rebate” shall mean the rebate described in Section 3.3 of this Exhibit A. |
1.13 | “Total Quality % Score” shall mean for any Quarter occurring during calendar year 2011, a percentage equal to (i) the sum of, for such Quarter, (A) the Greater Than [DELETED] Requirement Rebate Score plus (B) the Less Than [DELETED] Requirement Rebate Score, divided by (ii) [DELETED] ([DELETED]) (i.e., the maximum achievable Greater Than [DELETED] Requirement Rebate Score and Less Than [DELETED] Requirement Rebate Score for such Quarter). For the avoidance of doubt, for purposes of calculating Total Quality % Score for the Term, no Dialysis Center Purchasers which have been added or removed during the Term shall be included in the Aggregate Greater than [DELETED] Percentage or the Aggregate Less than [DELETED] Percentage of such calculation and the Aggregate Greater Than [DELETED] Baseline Performance and the Aggregate Less Than [DELETED] Baseline Performance shall remain unchanged. |
2 | MAXIMUM GROWTH LIMITATION. The rebates Dialysis Center may be eligible to receive as set forth in this Exhibit A are subject to the following limitation. |
2.1 | Maximum Growth Limitation. The rebates set forth in this Exhibit A shall only be paid to Dialysis Center on aggregate Qualified Gross Purchases made during any Quarter that do not exceed [DELETED] percent ([DELETED]%) of the aggregate Qualified Gross Purchases made in the immediately preceding Quarter. Such calculation shall be adjusted pursuant to Sections 2.2 and 3.4 of the Agreement to reflect any Dialysis Center Purchasers added or removed during such period and to remove from the calculation the effect of any change in [DELETED] during the relevant comparison periods. |
2.2 | Amgen may, in its sole discretion, determine that Dialysis Center may be eligible to receive rebates on Qualified Gross Purchases over [DELETED] percent ([DELETED]%) if such Qualified Gross Purchases are predicated upon increases in actual patient utilization and increases in the number of Dialysis Center’s patients. Amgen shall make such determination based upon a review of all relevant reports including, but not limited to: monthly forecast reports, the national accounts monthly purchase reports, historical purchase reports, appropriate wholesaler data, and any finance reports. Such determination must be approved by Xxxxx’s Corporate Accounts Senior Management. |
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3 | PRODUCT REBATES |
3.1 | Base Rebate. Dialysis Center shall earn the Base Rebate for each Quarter during the Term as described below in this Section 3.1 of this Exhibit A. |
3.1.1 | Calculation of Base Rebate. Dialysis Center shall receive an [DELETED] percent ([DELETED]%) base rebate payment (the “Base Rebate”). The Base Rebate will be calculated as a percentage of the Qualified Gross Purchases during each Quarter. |
3.1.2 | Payment of Base Rebate. Amgen will pay the Base Rebate within [DELETED] ([DELETED]) days after the end of the corresponding Quarter. |
3.1.3 | Vesting of Base Rebate. The Base Rebate for a given Quarter shall vest on the last day of such Quarter. |
3.2 | Special Price Rebate. Dialysis Center shall earn the Special Price Rebate for each Quarter during the Term in the manner described below in this Section 3.2 of this Exhibit A. |
3.2.1 | Trigger Event for Special Price Rebate. If within any Quarter during the Term, Amgen [DELETED] by an amount which causes [DELETED] to exceed [DELETED], then Dialysis Center Purchasers shall be entitled to the Special Price Rebate as calculated in Section 3.2.2 of this Exhibit A. The Special Price Rebate shall apply to all Qualified Gross Purchases from the date of the related [DELETED] until the date (if any) at which [DELETED] is [DELETED] to or [DELETED] during the Term. |
3.2.2 | Calculation of Special Price Rebate. Amgen shall determine the amount of Dialysis Center’s Special Price Rebate for any Quarter by calculating the product of (i) Qualified Gross Purchases during such Quarter which purchases have been made while [DELETED] and (ii) the Special Price Rebate Percentage for such Quarter. |
3.2.3 | Payment of Special Price Rebate. Amgen will pay the Special Price Rebate within [DELETED] ([DELETED]) days after the end of the corresponding Quarter. |
3.2.4 | Vesting of Special Price Rebate. The Special Price Rebate for a given Quarter shall vest on the last day of such Quarter. |
3.3 | Quality Rebate. Dialysis Center shall earn the Quality Rebate for each Quarter during the Term provided Dialysis Center Purchasers meet the requirements described below in this Section 3.3 of this Exhibit A. |
3.3.1 | Qualification Criteria. To receive a Quality Rebate on Qualified Gross Purchases during a Quarter, Dialysis Center Purchasers must submit all hemoglobin test results for each dialysis patient and the date of each such test, as set forth in Schedule 1 of this Agreement, from at least [DELETED] percent ([DELETED]%) of all Dialysis Center Purchasers in accordance with the submission of data requirement set forth in Section 3.4.1 of this Exhibit A; provided, however, that if such [DELETED] percent ([DELETED]%) threshold is not met in any month due to the inclusion of de novo facilities that have not yet treated patients and/or inactive facilities, Amgen shall exclude any such facilities identified by Amgen and Dialysis Center from such month when calculating Dialysis Center’s eligibility for the Quality Rebate at the end of each Quarter. For purposes of clarity, the [DELETED] percent ([DELETED]%) will not include Dialysis Center Purchasers that are acute facilities. |
3.3.2 | Calculation of Average Patient Hemoglobin. Each calendar month during the Term, Amgen shall determine the average hemoglobin value for each patient of Dialysis Center Purchasers by adding all hemoglobin value test results for each such patient of Dialysis Center Purchasers during each such calendar month based on the Data provided by |
Page 24 of 54
Dialysis Center to Amgen and dividing the sum by the number of tests for the hemoglobin value of each such patient of Dialysis Center Purchasers performed by the Dialysis Center Purchasers during each such calendar month (the “Individual Patients with Hemoglobin Averages”). Each hemoglobin test for a patient must be derived from blood samples taken using any automated red blood cell counter testing method (e.g. Xxxxxxx-counter, Bayer-Technicon, Sysmex, CellDyne, etc.) given immediately prior to any dialysis treatment for such patient. Each test result must be reported to the nearest tenth of one gram per deciliter (0.1 g/dL). |
3.3.3 | Aggregate Greater Than [DELETED] Percentage Calculation. Each Quarter the Aggregate Greater than [DELETED] Percentage shall be calculated by adding all Individual Patients with Hemoglobin Averages in each calendar month that are greater than [DELETED] g/dL and dividing the sum by the total number of Individual Patients with Hemoglobin Averages for that calendar month (the “Monthly Greater Than [DELETED] Percentage”). The Monthly Greater than [DELETED] Percentage for each calendar month during a Quarter are then added and divided by [DELETED] ([DELETED]) to determine the “Aggregate Greater Than [DELETED] Percentage” for such Quarter. |
3.3.4 | Aggregate Less Than [DELETED] Percentage Calculation. Each Quarter the Aggregate Less than [DELETED] Percentage shall be calculated by adding all Individual Patients with Hemoglobin Averages in each calendar month that are less than [DELETED] g/dL and dividing the sum by the total number of Individual Patients with Hemoglobin Averages for that calendar month (the “Monthly Less Than [DELETED] Percentage”). The Monthly Less Than [DELETED] Percentage for each calendar month during a Quarter are then added and divided by [DELETED] ([DELETED]) to determine the “Aggregate Less Than [DELETED] Percentage” for such Quarter. |
3.3.5 | Calculation of Quality Rebate. For each Quarter, Amgen shall calculate the amount of Dialysis Center’s Quality Rebate by multiplying Qualified Gross Purchases during such Quarter by the applicable Quality Rebate Percentage set forth in the Quality Rebate Table below corresponding to the applicable Total Quality % Score for such Quarter. |
Quality Rebate Table | ||
Total Quality % Score |
Quality Rebate Percentage | |
[DELETED]% - [DELETED]% |
[DELETED]% | |
[DELETED]% - [DELETED]% |
[DELETED]% | |
[DELETED]% - [DELETED]% |
[DELETED]% | |
[DELETED]% - [DELETED]% |
[DELETED]% | |
[DELETED]% and below |
[DELETED]% |
3.3.6 | Payment of Quality Rebate. Amgen will pay the Quality Rebate within [DELETED] ([DELETED]) days after the end of the corresponding Quarter. |
3.3.7 | Vesting of Quality Rebate. The Quality Rebate for a given Quarter shall vest on the last day of such Quarter. |
3.4 | [DELETED] Rebate. Dialysis Center shall qualify for the [DELETED] Rebate (the “[DELETED] Rebate”) for a given Quarter provided all Dialysis Center Purchasers provide to Amgen the Data set forth in Schedule 1, and provided Dialysis Center meets the requirements described below in this Section 3.4 of this Exhibit A. |
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3.4.1 | Submission of Data Requirement. Subject to the validity of a Certification as described in Section 4 of this Agreement, Dialysis Center Purchasers must provide to Amgen the Data in a machine readable format acceptable to Amgen (Excel; or text file that is tab delimited, comma delimited, colon delimited or space delimited including a line of column headers identifying the column contents and units, if applicable). The Data files shall contain record counts for each file contained in the data submission; provided, however, that Dialysis Center shall be required to submit such test results only for those dialysis patients whose test results are actually determined by laboratories owned and operated by Dialysis Center. |
3.4.2 | Calculation of [DELETED] Rebate. Provided Dialysis Center has fulfilled all requirements described in this Section 3.4 of this Exhibit A, Dialysis Center shall be eligible to receive a [DELETED] percent ([DELETED]%) [DELETED] Rebate payment. The [DELETED] Rebate will be calculated as a percentage of the Qualified Gross Purchases during each Quarter. |
3.4.3 | Payment of [DELETED] Rebate. The Data must be submitted, on a calendar monthly basis by the last day of the following calendar month (or the next business day if such last day is not a business day). If the Data is received after such timeframe for any month within a given Quarter, the total Qualified Gross Purchases during such month will be excluded from the calculation of the [DELETED] Rebate for that Quarter. Notwithstanding the foregoing, if Amgen receives all required Data from a minimum of [DELETED] percent ([DELETED]%) of all Dialysis Center Purchasers within the time frame referenced above for any calendar month within a given Quarter, the total Qualified Gross Purchases during such calendar month, will be included in the calculation of the [DELETED] Rebate for that Quarter; provided that for purposes of clarity, the [DELETED] percent ([DELETED]%) will not include Dialysis Center Purchasers that are acute facilities. Failure of Dialysis Center to qualify under this Section 3.4 of this Exhibit A during a particular Quarter shall not affect Dialysis Center’s eligibility to qualify during any other Quarter, nor shall Dialysis Center’s qualification during a particular Quarter automatically result in qualification during any other Quarter. If Amgen receives all required Data from less than [DELETED] percent ([DELETED]%) of Dialysis Center Purchasers for any calendar month within a given Quarter, no Qualified Gross Purchases during such calendar month will be included in the calculation of the [DELETED] Rebate for that Quarter; provided, however, that if such [DELETED] percent ([DELETED]%) threshold is not met in any month due to the inclusion of de novo facilities that have not yet treated patients and/or inactive facilities, Amgen shall exclude any such facilities identified by Amgen and Dialysis Center from such month when calculating Dialysis Center’s eligibility for the [DELETED] Rebate at the end of each Quarter. However, if Amgen determines that any Dialysis Center Purchaser is consistently not submitting the required Data, Amgen and Dialysis Center will work collaboratively in resolving such inconsistencies. Amgen will use commercially reasonable efforts to notify Dialysis Center in writing, no later than fifteen (15) business days after the receipt and acceptance by Amgen of the Data of the identity of all Designated Affiliates and/or Designated Managed Centers, if any, which have failed to meet the Data submission requirements for that month. Amgen reserves the right, in its sole discretion, to exclude any Qualified Gross Purchases of any Designated Affiliate and/or Designated Managed Center that is consistently non-reporting from the calculation of the [DELETED] Rebate for any relevant Quarter. Amgen will pay such |
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[DELETED] Rebate within [DELETED] ([DELETED]) days after the end of the corresponding Quarter provided Amgen is in receipt of all Data in the form and in the time period described in Section 3.4.1 of this Exhibit A. If the failure of Dialysis Center to deliver any such Data is a result of a Certification not being valid due to Amgen’s failure to satisfy any Certification Requirement (as described in Section 4 of this Agreement) then the [DELETED] Rebate shall still be available to Dialysis Center and payable by Amgen, in which case Dialysis Center shall deliver the Data to Amgen as soon as the Certification becomes valid. Upon a valid Certification being issued, Dialysis Center shall submit to Amgen all Data dating back to the date Dialysis Center stopped submitting the Data to Amgen within thirty (30) days. |
3.4.4 | Vesting of [DELETED] Rebate. The [DELETED] Rebate for a given Quarter shall vest on the last day of such Quarter. |
3.5 | [DELETED] Milestone Rebate. Dialysis Center shall qualify for the [DELETED] Milestone Rebate (the “[DELETED] Rebate”) for each Quarter during the Term provided it meets the requirements described below in this Section 3.5 of this Exhibit A. The purpose of the [DELETED] Rebate is to improve the transmission, quality and validation of all Data sent from Dialysis Center to Amgen, such that the processes used by both parties are more efficient and timely. |
3.5.1 | Requirements. For each Quarter during the Term the following requirements shall be met to earn the [DELETED] Rebate: |
3.5.1.1 | Dialysis Center must adhere to the process for Data transmission agreed upon with Amgen following any acquisition of a facility or facilities by Dialysis Center and/or a merger of Dialysis Center. |
3.5.1.2 | Dialysis Center shall participate in quarterly [DELETED] meetings with Amgen to discuss the status of each project, with additional meetings as required. |
3.5.1.3 | Dialysis Center shall cooperate with Amgen to define roles and responsibilities, contacts, and communication escalation process. |
3.5.1.4 | Dialysis Center shall adhere to the process for mapping revised patient IDs to previous patient IDs whenever identification systems change. |
3.5.1.5 | Dialysis Center shall collaborate with Amgen to review and monitor processes to assure that submission of the Data contained in this Exhibit A meet standards for [DELETED] or [DELETED] for [DELETED] and [DELETED] submission, and the use of [DELETED] and [DELETED]for [DELETED] and [DELETED] submissions. |
3.5.1.6 | Dialysis Center shall use its best efforts to deliver the Data to Amgen in twenty-five (25) days or less. |
3.5.1.7 | Dialysis Center shall continue to collaborate with Amgen to develop business processes to re-define limits for out of limits reports and resolve unusual numbers of re-defined out-of-limits Data in submissions. |
3.5.1.8 | Dialysis Center shall adhere to the agreed upon process for notifying Amgen of new Dialysis Center acquisitions and de novo facilities. |
3.5.1.9 | Dialysis Center shall meet with Amgen during the first Quarter of the Term to develop a mutually agreeable plan of action intended to develop and improve the methods of exchanging the Data between Dialysis Center and Amgen (a “Plan of Action”). The Plan of Action shall be set forth in a detailed written plan and attached as an addendum to this Agreement on or before the end of the first Quarter of the Term. |
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The Plan of Action shall include detailed deliverables and activities on a specific timeline for the remainder of the Term. The deliverables and timeline goals set forth in the Plan of Action shall be used to determine the requirements for earning the [DELETED] Rebate in the second Quarter of the Term. |
3.5.1.10 | To qualify for the [DELETED] Rebate during the second Quarter of the Term, Dialysis Center must achieve the second Quarter goals as set forth in such Plan of Action; provided, that the only requirement for Dialysis Center to earn the [DELETED] Rebate during the first Quarter of the Term shall be to develop a Plan of Action for the Term. |
3.5.2 | Calculation of [DELETED] Rebate. Provided Dialysis Center has fulfilled all requirements described in this Section 3.5 of this Exhibit A, Dialysis Center shall be eligible to receive a [DELETED] percent ([DELETED]%) [DELETED] Rebate payment. The [DELETED] Rebate will be calculated as a percentage of the Qualified Gross Purchases during each Quarter. |
3.5.3 | Payment of [DELETED] Rebate. Amgen will pay the [DELETED] Rebate within [DELETED] ([DELETED]) days after the end of the corresponding Quarter. |
3.5.4 | Vesting of [DELETED] Rebate. The [DELETED] Rebate for a given Quarter shall vest on the last day of such Quarter. |
3.6 | Project Rebate. Dialysis Center shall earn the Project Rebate for each Quarter during the Term provided it continues the [DELETED] and meets the requirements described below in this Section 3.6 of this Exhibit A. |
3.6.1 | Project Rebate Requirements. Dialysis Center shall meet the following requirements: |
3.6.1.1 | provide a [DELETED] written summary report regarding related activities undertaken in the first Quarter of the Term; |
3.6.1.2 | provide any copies of abstracts and/or manuscripts related to the [DELETED] at the time they were [DELETED], if permissible to [DELETED], or if not permissible, then as soon as [DELETED], in the first Quarter of the Term during that Quarter; |
3.6.1.3 | provide a [DELETED] written summary report regarding related activities undertaken in the second Quarter of the Term; |
3.6.1.4 | provide any copies of abstracts and/or manuscripts related to the [DELETED] at the time they were [DELETED], if permissible to [DELETED], or if not permissible, then as soon as [DELETED], in the second Quarter of the Term during that Quarter; and |
3.6.1.5 | participate in meetings with Amgen to discuss the status of the [DELETED]. |
3.6.2 | Calculation of Project Rebate. Provided Dialysis Center has fulfilled all requirements described in this Section 3.6 of this Exhibit A, Amgen shall calculate the amount of Dialysis Center’s Project Rebate each Quarter during the Term by multiplying Qualified Gross Purchases during each such Quarter during the Term by [DELETED] percent ([DELETED]%). |
3.6.3 | Payment of Project Rebate. Amgen will pay the Project Rebate within [DELETED] ([DELETED]) days after the end of the corresponding Quarter. |
3.6.4 | Vesting of Project Rebate. The Project Rebate for each Quarter shall vest on the last day of each such Quarter. |
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4 | SUMMARY OF DISCOUNTS |
Provided Dialysis Center has fulfilled all discount requirements and the highest levels of performance described in this Exhibit A, the total discount opportunity is as set forth in the Summary of Discounts Table below.
Summary of Discounts Table | ||||
Invoice Discount |
[DELETED | ]% | ||
Base Rebate |
[DELETED | ]% | ||
Projects Rebate |
[DELETED | ]% | ||
Quality Incentive Rebate |
[DELETED | ]% | ||
[DELETED] Rebate |
[DELETED | ]% | ||
[DELETED] Rebate |
[DELETED | ]% | ||
Total Discount Opportunity |
[DELETED | ]% |
Page 29 of 54
Exhibit B
Authorized Wholesalers
ASD Specialty Healthcare, Sub of ABC Specialty Group
Addison, TX
CMA 600615
AmerisourceBergen Drug Corporation
Thorofare, NJ
CMA 600124
Page 30 of 54
Exhibit C
Designated Affiliates
Page 31 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita 3185 Athens Acutes | 15953 Athens Limestone Dr | Athens | AL | 35611 | E54OU1600 | 211011 | ||||||
Davita Athens At Home #6283 | 15953 Athens Limestone Dr | Athens | AL | 35611 | 78A67TV00 | 1275554 | ||||||
Davita Athens Dialysis #4036 | 15953 Athens Limestone Dr | Athens | AL | 35613 | 9BB27RV00,KJ1N6YV00 | 1453078 | ||||||
Atmore Dialysis Center | 000 Xxxx Xxxxx Xxxxxx | Xxxxxx | XX | 00000 | 000XX0000 | 288587 | ||||||
Xxxxxx Xxxxxxxx | 000 Xxxxxxxx Xxxx, Xxxxx 000 | Xxxxxxxx | XX | 00000 | K4CGV3E00 | 276620 | ||||||
Davita - Center Point Dialysis | 0000 0xx Xxxxxx Xxxxx Xxxx | Xxxxxxxxxx | XX | 00000 | 00XX0XX00 | 1378709 | ||||||
Davita 2614 Birmingham East | 0000 X. Xxxx Xx | Xxxxxxxxxx | XX | 00000 | XXX0X0X00 | 211019 | ||||||
Davita 3377 Birmingham Central | 000 Xxxxxxx Xxxxxxxxx Xxxx X. | Xxxxxxxxxx | XX | 00000 | 6BHEKQM00 | 276622 | ||||||
Davita 0000 Xxxxxxxxxx Xxxxx | 0000 00xx Xxx X. | Xxxxxxxxxx | XX | 00000 | E8WR6AP00 | 281080 | ||||||
Davita 3382 Xxxxxx | 0000 Xxxxxx X. | Xxxxxxxxxx | XX | 00000 | 6H96HWF00 | 276621 | ||||||
Davita Birmingham At Home | 0000 0xx Xxx X. | Xxxxxxxxxx | XX | 00000 | 8CV5EMK00 | 276625 | ||||||
Davita Birmingham Home Training | 0000 0xx Xxx X. | Xxxxxxxxxx | XX | 00000 | 92M45BH00 | 1419399 | ||||||
Davita 3343 Boaz | 00 Xxxxxxx Xxxxxxxxx Xx | Xxxx | AL | 35957 | 80LVW7R00 | 278779 | ||||||
Davita- Home Dialysis Options of South Xxxxxxx | 00000 Xxxxx Xxxx Xxxxxx, Xxxxx X | Xxxxxx | XX | 00000 | 10K8TBX00 | 1283018 | ||||||
Davita 2616 Demopolis | 000 X. Xxxxx Xxx | Xxxxxxxxx | XX | 00000 | 3P27HQ800 | 219555 | ||||||
Davita 2609 Dothan | 000 Xxxxxxxxx Xx | Xxxxxx | XX | 00000 | X0XXXXX00 | 211021 | ||||||
Davita Wire Grass Kidney Center #4343 Dialysis | 0000 Xxxx Xxxxx Xxx Xxx 000 | Xxxxxx | XX | 00000 | CBFVW2V00 | 1463992 | ||||||
Davita- Dothan At Home | 000 Xxxxxxxxx Xx | Xxxxxx | AL | 36305 | 7CD879K00 | 1282869 | ||||||
Physicians Choice Dialysis of Alabama, LLC - East Montgomery | 0000 Xxxxxx Xxxxxx Xxxxxxxxx | Xxxx Xxxxxxxxxx | XX | 00000 | LMAL1BE00 | 229816 | ||||||
Davita 3610 Eufaula | 000 X. Xxxxxx Xxx | Xxxxxxx | XX | 00000 | G29T15Q00 | 345409 | ||||||
Xxxxxx Xxxxxx County Dialysis | 000 Xx Xxxxxxx 00 | Xxxxx | XX | 00000 | 4BN24X500 | 228975 | ||||||
Davita - Fayette Dialysis | 0000 Xxxxxx Xxxxxx Xxxxx | Xxxxxxx | XX | 00000 | 7751J2500,Y0H9B3200 | 226802 | ||||||
Davita 3131 Xxxxxxxx Xxxxxxxx | 000 X. Xxxxxx Xxxxx Xxxx Xxx X. | Xxxxxxxx | XX | 35630 | 1JD9E5P00 | 210999 | ||||||
Davita Renaissance At Home #56956 | 1840 Xxxxx Dr | Florence | AL | 35630 | 5KMGVBX00 | 1612613 | ||||||
Davita Renaissance Dialysis Center | 1840 Xxxxx Dr | Florence | AL | 35630 | 00XXXXX00 | 1454023 | ||||||
Davita #1756 South Xxxxxxx Dialysis | 000 Xxxx Xxxxxxxxx Xxxxxx | Xxxxx | XX | 00000 | F0T269P00 | 234804 | ||||||
Davita South Xxxxxxx At Home | 000 X. Xxxxx Xxxx Xxxxxx | Xxxxx | XX | 00000 | E6000L500 | 1405155 | ||||||
Xxxxxx Xxxxxxx | 000 X. 0xx Xx. | Xxxxxxx | XX | 35901 | L01R4VC00 | 211025 | ||||||
Davita Gulf Shores Dialysis Center # 4402 | 0000 Xxxx Xxxxxx Xxxxxxx Xxx 00 | Xxxx Xxxxxx | XX | 00000 | FKFDQ4L00 | 1474592 | ||||||
Davita Pdi Montgomery At Home | 0000 Xxxxxx Xxx | Xxxxxxxxxx | XX | 00000 | 7FR1P2500 | 1621100 | ||||||
Physicians Choice Dialysis - Montgomery | 1000 Xxxxxx Xxx | Xxxxxxxxxx | XX | 00000 | XX0XXX000,XE0RZI5F1 | 208999 | ||||||
Davita Muscle Shoals Dialysis Center #4300 | 000 Xxxxx Xx. | Xxxxxx Xhoals | AL | 35661 | 37NA3HR00 | 1617076 | ||||||
Davita 3619 Northport | 2401 Hospital Dr | Northport | AL | 35476 | GH8G6E500 | 232929 | ||||||
Davita Opelika Center At Home Dialysis # 5970 | 2340 Pepperell Pkwy | Opelika | AL | 36801 | 59HBJ0P00,C5HBJRJ00 | 1468186 | ||||||
Davita 3092 Ozark | 214 Hospital Ave | Ozark | AL | 36360 | FVE79SW00 | 219823 | ||||||
Davita # 0843 Phenix City Dialysis Center | 1900 Opelika Road | Phenix City | AL | 36867 | EZJ75T100 | 211005 | ||||||
Xxxxxx - Xxx Xxxxxxx Acutes # 1072 Dialysis | 1815 Glynwood Drive | Prattville | AL | 36066 | 2LEOWH200,HJANXJD00 | 208998 | ||||||
Davita 2601 Rainbow City-Gadsden East | 2800 Rainbow Dr | Rainbow City | AL | 35906 | 3292XJW00 | 219706 | ||||||
Davita Rainbow City - At Home Clinic #6282 | 2800 Rainbow Drive | Rainbow City | AL | 35906 | K5CYNM800 | 1272830 | ||||||
Davita 3485 Russellville | 14897 Highway 43 | Russellville | AL | 35653 | 00XX0X000 | 286084 | ||||||
Davita 3038 Sheffield | 1120 X. Xxxxxxx Hwy Ste 107 | Sheffield | AL | 35660 | HHWADVC00 | 229652 | ||||||
Davita 3383 Sylacauga | 331 Xxxxx Xxxxxx Blvd | Sylacauga | AL | 35150 | 70CLJBY00 | 228560 | ||||||
Davita Sylacauga At Home | 331 Xxxxx Xxxxxx Blvd | Sylacauga | AL | 35150 | 7HMFX4Q00,00XXXXX00 | 1275550 | ||||||
Davita-Talladega | 726 Battle Street East, Suite A | Talladega | AL | 35160 | LDF1QAE00 | 1282920 | ||||||
Davita 2615 Tuscaloosa | 805 Old Mill St. | Tuscaloosa | AL | 35401 | 0X0XXX000 | 220759 | ||||||
Davita 3206 Tuscaloosa University | 220 15th St. | Tuscaloosa | AL | 35401 | F779RXQ00 | 216420 | ||||||
Davita Tuscaloosa At Home | 805 Old Mil Street | Tuscaloosa | AL | 35401 | 8J9H90Q00 | 1275826 | ||||||
Physicians Choice Dialysis of Alabama, LLC - Xxxxxx | 515 Hospital Drive | Wetumpka | AL | 36092 | 79V7B2V00 | 229116 | ||||||
Davita - Bentonville Dialysis | 1104 Se 30th St. | Bentonville | AR | 72712 | C0PW2KJ00 | 231830 | ||||||
Davita - Fayetteville Dialysis | 509 East Xxxxxxx Road, Suite 111 | Fayetteville | AR | 72703 | 08BJM8W00 | 231812 | ||||||
Xxxxxx Xxxxxxx City Dialysis Center #4430 | 1501 X. Xxxxxxxxxx St. | Forrest City | AR | 72335 | X0XX00X00 | 1496577 | ||||||
Davita 6237 Jacksonville Central At Home Dialysis | 400 X. X. Xxxxx Dr | Jacksonville | AR | 72076 | 3G53PDT00 | 1472869 | ||||||
Davita Jacksonville Central Dialysis | 400 X. X. Xxxxx Dr | Jacksonville | AR | 72076 | X00XXXX00 | 277577 | ||||||
Davita | 5800 W. 10th St. Ste 510 | Little Rock | AR | 72204 | AGDAYV600 | 306196 | ||||||
Davita Central Little Rock Dialysis 3615 | 5800 West 10th Street, Suite 510 | Little Rock | AR | 72204 | AGDAYV6F1 | 345988 | ||||||
Davita- Central Little Rock At Home | 5800 West 10th Street, Suite 510 | Little Rock | AR | 72204 | X0XXX0X00 | 1282870 | ||||||
Davita-Mena Dialysis | 1200 Crestwood Circle | Mena | AR | 71953 | DL7W97H00 | 1283203 | ||||||
Davita Little Rock Clinic | 4505 East Mccain Boulevard | North Little Rock | AR | 72117 | X00XXXX00 | 277174 | ||||||
Davita - Siloam Springs Dialysis | 500 South Mount Olive, Suite 107 | Siloam Springs | AR | 72761 | 5G7F63G00 | 276279 | ||||||
Davita - Springdale Dialysis | 708 Xxxxxx St. | Springdale | AR | 72764 | 2HFBM5000,76GDD2L00 | 233801 | ||||||
Davita Ocotillo Dialysis Center #4405 | 975 X. Xxxxxxxx Heights Rd Bldg A Ste 101 | Chandler | AZ | 85248 | D5A03YT00 | 1624061 | ||||||
Davita Chinle Dialysis Facility | U.S. Highway 191, PO Box 879 | Chinle | AZ | 86503 | W6BTS4200 | 208876 | ||||||
Southwest Kidney - Davita Dialysis Partners, LLC Dba: Gilbert - Dialysis Center | 5222 East Baseline Road, Suite 104 | Gilbert | AZ | 85234 | 0X0X0XX00 | 1116217 | ||||||
Davita - Phoenix At Home | 20325 North 51st Ave Bldg 11, Suite 184 | Glendale | AZ | 85308 | 279Q2BL00 | 1404383 | ||||||
Davita Brookwood Dialysis Center #4374 | 8910 N. 43rd Ave Ste 107 | Glendale | AZ | 85302 | 80XT8AG00 | 1487927 | ||||||
Southwest Kidney -Davita Dialysis Partners,LLC Dba: Arrowhead Lakes - Dialysis Center | 20325 N. 51st Ave Bldg 11 Ste 186 | Glendale | AZ | 85308 | 7J8HWLW00 | 1272775 | ||||||
Davita Kayenta Dialysis Facility | Highway 163, PO Box 217 | Kayenta | AZ | 86033 | FTGBQH600 | 230300 | ||||||
Davita - Mountain Vista Dialysis Center # 1952 | 10238 X. Xxxxxxx Ave Ste 108 | Mesa | AZ | 85209 | B427AXV00 | 1272776 | ||||||
Davita 4355 Central Mesa Dialysis Center | 1134 E. University Dr Ste 101 | Mesa | AZ | 85203 | ABYQH0Q00 | 1453991 | ||||||
Xxxxxx Xxxxxxx | 1231 West Target Range Road | Nogales | AZ | 85621 | LXRQZCA00 | 224088 | ||||||
Davita - Rim County Dialysis Center | 809 West Longhorn Road | Payson | AZ | 85541 | 5FBGBTF00 | 1289320 | ||||||
Davita 4364 Maryvale Dialysis Center | 4845 X. Xxxxxxxx Rd Ste 10 | Phoenix | AZ | 85035 | 47N1VVP00 | 1463383 | ||||||
Xxxxxx Xxxxxxxx Dialysis #1936 | 8410 Xxxx Xxxxxx Road Building 1, Suite 100 | Phoenix | AZ | 85037 | 6458A1Y00 | 1256521 | ||||||
Davita Raven Dialysis Center # 4371 | 3540 E. Baseline Rd Ste 110 | Phoenix | AZ | 85042 | 011RJBN00 | 1463990 | ||||||
Papago Dialysis Center | 1401 North 24th Street, Suite 2 | Phoenix | AZ | 85008 | RM5YBH800 | 228652 | ||||||
Southwest Kidney -Davita Dialysis Partners,LLC Dba:Phoenix Dialysis Center | 337 East Coronado Road, Suite 101 | Phoenix | AZ | 85004 | K0LRG4G00 | 1229004 | ||||||
Davita Dialysis Unit - Hopi Health Care Center | Highway 264- Mile Marker 388 | Polacca | AZ | 86042 | LD37BQ900 | 285886 | ||||||
Davita | 20201 North Scottsdale Healthcare Drive Suite 100 | Scottsdale | AZ | 85255 | A1CQFNF00 | 1157912 | ||||||
Davita #2022, Dba: Scottsdale Dialysis Center | 4725 N. Scottsdale Rd Ste 100 | Scottsdale | AZ | 85251 | X0XX0X000 | 210979 | ||||||
Xxxxxx Xxxxxxxxx At Home Hemo #6000 | 7321 East Xxxxxx Drive | Scottsdale | AZ | 85251 | 8N99LTR00 | 347013 | ||||||
Davita Desert Mountain Dialysis | 9220 East Mountainview Road, Suite 105 | Scottsdale | AZ | 85258 | O9DBU6L00 | 208881 | ||||||
Davita 3000 Xxxxx | Xxxxxxx 00, Indian Health Service Hospital | Sells | AZ | 85634 | XXXXXXX00 | 220404 | ||||||
Davita - Sierra Vista | 620 Xxxxx Xxxxxxx, Xxxxxx 00, Suite 6 and 7 | Sierra Vista | AZ | 85635 | UVKRVQL00 | 220405 | ||||||
Davita #2038 Palm Brook Dialysis Center | 14664 North Xxx Xxxx Boulevard | Sun City | AZ | 85351 | 3GD2X9400 | 1050793 | ||||||
Davita-Xxxxxxxxx Dialysis | 13907 W. Camino Del Sol | Sun City | AZ | 85375 | DFLXTDG00 | 1285478 | ||||||
Davita - Grand Home | 14674 W. Mountain View Blvd Ste 204 | Surprise | AZ | 85374 | CKQTHGC00 | 1414181 | ||||||
Southwest Kidney - Davita Dialysis Partners, LLC Dba: Tempe - Dialysis Center | 2149 East Warner Road, Suite 110 | Tempe | AZ | 85284 | X0XXXXX00 | 1142180 | ||||||
Southwest Kidney -Davita Dialysis At Home | 2149 East Warner Road, Suite 109 | Tempe | AZ | 85284 | G6EVBKQ00 | 1142181 | ||||||
Davita Tuba City | 500 Edgewater Drive | Tuba City | AZ | 86045 | HN9P7T200 | 210978 | ||||||
Davita - Tucson East At Home | 6420 E. Broadway Blvd Ste C300 | Tucson | AZ | 85710 | CJQ80XQ00 | 219949 | ||||||
Davita - Tuscon Central Dialysis Center # 2427 | 2901 X. Xxxxx Rd | Tucson | AZ | 85716 | 8739WQD00 | 1461559 | ||||||
Davita - West Tucson | 1780 West Xxxxxx Road | Tucson | AZ | 85745 | 3JFWVB300 | 219948 | ||||||
Davita 3203 Tucson South | 3662 South 16th Avenue | Tucson | AZ | 85713 | G8796HR00 | 230250 | ||||||
Davita 3261 Xxxxxx Yaqui | 7490 South Camino De Oeste | Tucson | AZ | 85746 | 01BMTMD00 | 235436 | ||||||
Davita Northwest Tucson | 2945 X. Xxx Rd Ste 105 | Tucson | AZ | 85741 | 00XXXXX00 | 1279375 | ||||||
Davita Xxxx Ranch Dialysis Center #4365 | 7355 X. Xxxxxxxx Rd Ste 101 | Tucson | AZ | 85747 | 27LJAQD00 | 1496576 | ||||||
Davita Tuscon East At Home | 6420 E. Broadway Blvd Suite-C300 | Tucson | AZ | 85710 | G5XVLLJ00 | 1436049 | ||||||
Davita Tuscon South Central | 2024 East Irvington Street, Suite 7 | Tucson | AZ | 85714 | KAW1PWC00 | 312189 | ||||||
Davita 2508 Yuma | 2130 West 24th Street | Yuma | AZ | 85364 | 53V70NX00 | 210981 | ||||||
Davita 3050 Yuma South | 3010 South Fourth Avenue | Yuma | AZ | 85364 | G6PRN0P00 | 229673 | ||||||
Davita 4057 Anaheim | 1107 West La Palma Avenue | Anaheim | CA | 92801 | Y8HYA5000 | 225957 | ||||||
Davita Anaheim West Dialysis # 2485 | 1821 X. Xxxxxxx Ave | Anaheim | CA | 92801 | E3J1D0E00 | 1720753 | ||||||
Antioch Dialysis Center | 3100 Delta Fair Boulevard | Antioch | CA | 94509 | 97VWKPG00 | 276603 | ||||||
Davita 3009 Xxxxxx Valley | 16049 Kamana Rd | Apple Valley | CA | 92307 | 04VFH5000 | 210846 | ||||||
Xxxxxx Xxxxxxx Dialysis | 580 East Bellvue Road | Atwater | CA | 95301 | PHY5JRJ00 | 221156 | ||||||
Davita 3860 Auburn | 3126 Professional Drive, Suite 100 | Auburn | CA | 95603 | GB82PND00 | 210795 | ||||||
Bakersfield Dialysis Center | 5143 Office Park Drive | Bakersfield | CA | 93309 | RJWB95V00 | 208911 | ||||||
Davita 3633 Bakersfield South | 7701 White Lane, Suite D | Bakersfield | CA | 93309 | 12182Q400 | 346968 | ||||||
Davita 3821 Northeast Bakersfield | 3761 Mall View Rd | Bakersfield | CA | 93306 | JL2JXRD00 | 275250 | ||||||
Xxxxxx Xxxxx Xxxx At Home #6251 Dialysis | 7701 White Ln | Bakersfield | CA | 93309 | BCVREQD00 | 1472951 | ||||||
Davita-Bakersfield Xxxxxxxx Dialysis #3820 | 8501 Xxxxxxxx Xx Bldg 500 | Bakersfield | CA | 93312 | BGP952W00 | 210775 |
Page 32 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita 2571 Banning | 6090 West Ramsey Street | Banning | CA | 92220 | F6TXF6W00 | 1069592 | ||||||
Xxxxxx Xxxxxxxxxx Dialysis Center | 15736 Xxxxxxxx Avenue | Bellflower | CA | 90706 | 5B08AA800 | 1256374 | ||||||
Davita 3109 Benicia | 560 First Street, Suite D-103 | Benicia | CA | 94510 | 62B2P1B00 | 235162 | ||||||
Davita 3039 Berkeley | 2920 Telegraph Ave | Berkeley | CA | 94705 | 8KK3B7X00 | 225070 | ||||||
Xxxxxx - Xxxxxxx Hills Dialysis Center | 50 X. Xx Xxxxxxx Boulevard, Suite 300 | Beverly Hills | CA | 90211 | CHVAG1F00 | 210809 | ||||||
Davita Brea Dialysis Center | 595 Tamarack Avenue, Suite A | Brea | CA | 92821 | 0X0X0X000 | 228035 | ||||||
Xxxxxx Xxxxxxx Dialysis | 1211 North San Xxxxxxxx Boulevard | Burbank | CA | 91504 | 97RDXVC00 | 210773 | ||||||
Xxxxxx Xxxxxxxxx Dialysis #5531 | 2438 N. Ponderosa Dr Ste C101 | Camarillo | CA | 93010 | HAJ0H6X00 | 1196807 | ||||||
Xxxxxx Xxxxxxxxx At Home #6016 | 4005 Manzanita Avenue, Suite 18 | Carmichael | CA | 95608 | AE6TWEX00 | 1199846 | ||||||
Davita Manzanita Dialysis | 4000 Xxxxxxxxx Xxxxxx, Xxxxx 00 | Xxxxxxxxxx | XX | 00000 | 0XX00XX00,XCYDDNY00 | 210805 | ||||||
Davita Manzanita Home Training Center #284 | 4005 Manzanita Ave Ste 18 | Carmichael | CA | 95608 | BFA08W400 | 1159910 | ||||||
Davita Ceres Dialysis Center | 1768 Xxxxxxxx Road, Suite 308 | Ceres | CA | 95307 | H051JY400 | 1269257 | ||||||
Chico Dialysis Center | 530 Cohasset Road | Chico | CA | 95926 | 7F6TTXB00 | 210853 | ||||||
South Chico Dialysis Center | 2345 Forest Avenue | Chico | CA | 95928 | FHJBTH000 | 1088736 | ||||||
Davita 3506 Chino | 4445 Riverside Dr | Chino | CA | 91710 | 87368GC00 | 227299 | ||||||
Antelope Dialysis Center, Dba: Total Renal Care-Antelope Clinic | 6406 Tupelo Drive, Suite A | Citrus Heights | CA | 95621 | AL1G07J00 | 210748 | ||||||
Davita Clearlake Dialysis Center | 14400 Olympic Dr | Clearlake | CA | 95422 | A05J76B00 | 1269258 | ||||||
Davita Gateway Plaza Dialysis Center #4320 | 1580 X. Xxxxxxxxx Ave | Compton | CA | 90220 | B03JLEW00 | 1612614 | ||||||
Davita Concord Dialysis Center #2066 | 2300 Stanwell Drive, Suite C | Concord | CA | 94520 | GJBFEQT00 | 1121255 | ||||||
Xx Xxxx - Xxxxxx Dialysis Center | 1820 Fullerton Avenue, Suite 180 | Corona | CA | 92881 | 107LACF00 | 210750 | ||||||
Davita 3614 Costa Mesa | 1590 Scenic Ave | Costa Mesa | CA | 92626 | 97G11MK00 | 347180 | ||||||
Davita Premier Dialysis | 7612 Atlantic Ave | Cudahy | CA | 90201 | 0XM3R9M00 | 229797 | ||||||
Davita | 1498 Southgate Ave Ste 101 | Daly City | CA | 94015 | PJGB62700 | 210860 | ||||||
Davita - Xxxx City At Home #6046 | 1498 Southgate Avenue, Suite 101 | Daly City | CA | 94015 | 34VKJTY00 | 1199934 | ||||||
Xxxxxx Xxxxxxxx Xxxx City Dialysis Center # 2265 | 2201 Xxxxxxxx Xxxxx Blvd | Daly City | CA | 94014 | 105CWFT00 | 1616909 | ||||||
Davita 4026 Delano | 905 Main Street | Delano | CA | 93215 | 0XX0XXX00 | 209007 | ||||||
Xxxxxx Xxxx Valley State Prison | 29393 Xxxxx Ave | Delano | CA | 93215 | B2GTC8600 | 1249679 | ||||||
Davita #2386 Joy of Dixon | 1640 X. Xxxxxxx St. | Dixon | CA | 95620 | GBA5HXK00 | 1449347 | ||||||
Davita #2218 Xxxxxx Landing | 11611 Bellflower Blvd | Downey | CA | 90241 | XX000XX00 | 1454001 | ||||||
Davita# 0617 Downey Dialysis Center | 8630 Xxxxxxxx Ave Ste 100 | Downey | CA | 90240 | J4QRDQ700 | 210833 | ||||||
Davita 3849 El Cerrito | 10690 San Pablo Ave | El Cerrito | CA | 94530 | RN80CYW00 | 232238 | ||||||
Davita Greater El Monte Dialysis Center | 1938 Tyler Avenue, Suite J-168 | El Monte | CA | 91733 | MWQGV3M00 | 217091 | ||||||
Rosemead Springs Dialysis Center #1518 | 3212 Rosemead Boulevard | El Monte | CA | 91731 | A96D89J00 | 345251 | ||||||
Davita - West Elk Grove Dialysis Center | 2208 Kausen Drive, Suite 100 | Elk Grove | CA | 95758 | KFYHX3E00 | 1285808 | ||||||
Davita Elk Grove Dialysis | 9281 Office Park Circle, Suite 105 | Elk Grove | CA | 95758 | E4QRH3J00 | 1121814 | ||||||
Davita 3486 Encinitas | 332 Santa Fe Drive, Suite 100 | Encinitas | CA | 92024 | 0XXXXXX00 | 230885 | ||||||
Davita # 1865 South Valley Dialysis | 17815 Ventura Blvd Ste 100 | Encino | CA | 91316 | 767JD5L00 | 226475 | ||||||
Davita #6196- South Valley At Home | 17815 Venutra Blvd., Suite 100 | Encino | CA | 91316 | 0JDAWAC00 | 1283237 | ||||||
Davita 3055 Escondido | 203 East Second Avenue | Escondido | CA | 92025 | B4FX39300 | 225208 | ||||||
Davita 3669 Escondido Home Training | 635 East Grand Avenue | Escondido | CA | 92025 | A81KJ0M00 | 1108717 | ||||||
Davita #2266 | 1116 West Visalia Road, Suite 106 | Exeter | CA | 93221 | 46MC0W400 | 1405275 | ||||||
Davita - Fairfield Dialysis Center | 4660 Central Way | Fairfield | CA | 94534 | J246MYF00 | 226982 | ||||||
Davita #4005 Fontana Dialysis | 17590 Foothill Blvd | Fontana | CA | 92335 | 7G6E01800 | 209059 | ||||||
Davita #1281 - Xxxxxx City Dialysis | 1261 E. Hillside Blvd | Foster City | CA | 94404 | 02JYVDR00 | 1454053 | ||||||
Davita - Fresno Pd | 568 East Xxxxxxx Avenue, Suite 301 | Fresno | CA | 93720 | 5C5W8TJ00 | 1378707 | ||||||
Davita 3593 Palm Bluffs | 770 West Pinedale | Fresno | CA | 93711 | 8ETR7R400 | 342102 | ||||||
Xxxxxx Xxx Tree #1786 | 2666 North Grove Industrial Drive, Suite 106 | Fresno | CA | 93727 | 11G36C300 | 1215141 | ||||||
Xxxxxx Xxx Tree Pd #1787 | 2666 North Grove Industrial Drive, Suite 106 | Fresno | CA | 93727 | BAF176E00 | 1215142 | ||||||
Davita Fresno | 1111 East Warner Avenue | Fresno | CA | 93710 | YOGG49V00 | 210801 | ||||||
Davita 3058 Fullerton | 238 Orangefair Avenue | Fullerton | CA | 92832 | D8PB0DY00 | 210894 | ||||||
Davita Crossroads Dialysis Center | 3214 Xxxxx Xxxxx Boulevard | Fullerton | CA | 92831 | XXXXXX000 | 1129613 | ||||||
Satellite Dialysis Xxxxxx Xx | 7800 Xxxxxx Cir Ste B. | Gilroy | CA | 95020 | 7E3B86D00 | 1170130 | ||||||
Davita Glendale | 1000 East Xxxxxx Avenue | Glendale | CA | 91205 | GF06MNA00 | 210778 | ||||||
Davita North Glendale Dialysis # 5530 | 1505 Xxxxxx Terrace, Suite 190 | Glendale | CA | 91206 | H2DTJJR00 | 1289129 | ||||||
Davita 3590 Penn Valley Home Training | 776 Xxxxxxx Xx Suite Aandb | Grass Valley | CA | 95949 | DKE7JFG00 | 1422496 | ||||||
Davita 3861 Grass Valley | 360 Crown Point Cir Suite 210 | Grass Valley | CA | 95945 | AD0W34Q00 | 235122 | ||||||
Davita Grass Valley At Home #6325 | 360 Crown Point Cir Suite 210 | Grass Valley | CA | 95945 | E4315NE00 | 1693012 | ||||||
Davita 3831 Hanford | 402 West Eighth Street | Hanford | CA | 93230 | 7GL26AQ00 | 210782 | ||||||
Davita Hawaiian Gardens #2455 | 12191 226th St. | Hawaiian Gardens | CA | 90716 | X0X0XXX00 | 1720923 | ||||||
Davita - Sunrise Dialysis Center, Inc. | 13039 Hawthorne Boulevard | Hawthorne | CA | 90250 | XX00XXX00 | 227252 | ||||||
Xxxxxx Xxxxxxx Dialysis Center | 21615 Hesperian Boulevard, Suite X. | Xxxxxxx | CA | 94541 | HFRBR7W00 | 208970 | ||||||
Total Renal Care - South Hayward Dialysis Center | 254 Xxxxxxx Street | Hayward | CA | 94544 | 3DG6XRQ00 | 278548 | ||||||
Davita Diamond Valley Dialysis Center | 1030 East Florida Avenue | Hemet | CA | 92543 | JKHVQ6B00 | 230271 | ||||||
Davita Hemet Dialysis Center | 3050 W. Florida Ave | Hemet | CA | 92545 | CGQJG5M00 | 210790 | ||||||
Davita Hesperia Dialysis Center # 2278 | 14135 Main St. Ste 501 | Hesperia | CA | 92345 | A06P0MR00 | 1474593 | ||||||
Davita Highland Ranch Dialysis #2475 | 7223 Church St. Ste A14 | Highland | CA | 92346 | 3KFJGCD00 | 1662312 | ||||||
Davita 3059 Huntington Beach | 16892 Bolsa Chica Street | Huntington Beach | CA | 92649 | 0F88CKR00 | 210769 | ||||||
Xxxxxx Xxxxxxxxxx Park Dialysis #2310 | 5942 Rugby Ave | Huntington Park | CA | 90255 | H5HRJ7K00 | 1702891 | ||||||
Davita 3001 Inglewood | 125 East Arbor Vitae | Inglewood | CA | 90301 | 24JJH7W00 | 210868 | ||||||
Davita 3212 Airport-Fka Inglewood | 4632 West Century Boulevard | Inglewood | CA | 90304 | Y3RQ5AX00 | 229073 | ||||||
Davita Imperial | 2738 West Imperial Highway | Inglewood | CA | 90303 | DEBW2HH00 | 225298 | ||||||
Davita Dialysis 3488-1 San Diego-Scripps Green Hospital-Acute | 10666 X. Xxxxxx Pines Rd | La Jolla | CA | 92037 | 2F9J71H00 | 1458313 | ||||||
Davita Dialysis 3488-4 - Scripps Memorial Hosp-Acute | 9888 Genesee Ave | La Jolla | CA | 92037 | BB0TKCB00 | 1458311 | ||||||
Davita 4061 Saddleback | 23141 Plaza Pointe Drive | Laguna Hills | CA | 92653 | DDK1HA200 | 235742 | ||||||
Lake Elsinore Dialysis | 32291 Mission Trail Road, Building S. | Lake Elsinore | CA | 92530 | HF5YFJX00 | 319618 | ||||||
Total Renal Care - Lakeport | 800 00xx Xxxxxx | Xxxxxxxx | XX | 00000 | XXXXXXX00 | 000000 | ||||||
Davita Lakewood Dialysis Center | 4645 Xxxxx Street | Lakewood | CA | 90712 | D46W2RC00 | 210867 | ||||||
Davita - Antelope Valley Dialysis Center | 1759 West Avenue J, Suite 102 | Lancaster | CA | 93534 | KKVV4EC00 | 210883 | ||||||
Davita #2334 | 3201 Xxxxxx Xx Suite 175 | Livermore | CA | 94551 | 49LA2HR00 | 1623982 | ||||||
Davita - Lodi Community Dialysis, Inc. | 1610 West Kettleman Lane, Suite D | Lodi | CA | 95242 | 79JYB7F00 | 228976 | ||||||
Davita - Tokay Dialysis Center #2016 | 312 Fairmont Ave Ste A | Lodi | CA | 95240 | 5F9RL9E00 | 346347 | ||||||
Davita Tokay Home Dialysis | 777 X. Xxx Xxxx, Suite L. | Lodi | CA | 95242 | K2VDHY900 | 1253588 | ||||||
Davita # 0438 United Dialysis Center | 3111 Long Beach Boulevard | Long Beach | CA | 90807 | 1F1G8KP00 | 210738 | ||||||
Davita - Xxxxx Knolls #2137 | 3744 Long Beach Blvd. | Long Beach | CA | 90807 | 30KNXT000 | 1288752 | ||||||
Davita Harbor UCLA - Mfi - Long Beach Dialysis Center | 1075 East Pacific Coast Highway | Long Beach | CA | 90806 | 4AMJKBE00 | 1219292 | ||||||
Davita Los Alamitos Dialysis Center #2344 | 4141 Katella Ave | Los Alamitos | CA | 90720 | 0B0A2BY00 | 1722255 | ||||||
Davita #1902 Xxxxxxxxx | 757 X. Xxxxxxxxxx Blvd | Los Angeles | CA | 90021 | B0YKYKB00 | 1449385 | ||||||
Davita #6023 Century City Home/Pd Dialysis | 10630 Santa Xxxxxx Blvd | Los Angeles | CA | 90095 | X0XX0XX00 | 1253324 | ||||||
Davita - Doctors Dialysis Center of East Los Angeles | 950 South Eastern Avenue | Los Angeles | CA | 90022 | ADXYF1Y00 | 219743 | ||||||
Davita - Xxxxxxx Xxxx Plaza Dialysis Center | 11854 Wilmington Avenue | Los Angeles | CA | 90059 | XX0X0XX00 | 281227 | ||||||
Davita - USC Kidney Center | 2310 Alcazar Street | Los Angeles | CA | 90089 | BDNKXF700 | 233509 | ||||||
Davita - University Park Dialysis Center | 3986 South Xxxxxxxx Street | Los Angeles | CA | 90037 | KFE9UN300 | 213820 | ||||||
Davita 2500 Xxx Xxxxxxx Xlaza Dialysis | 1700 X. Xxxxx Xxxxxx Ave Ste L. 100 | Los Angeles | CA | 90033 | KA3QKQX00 | 225299 | ||||||
Davita 3565 Tower | 8635 West 3rd Street, Suite 560w | Los Angeles | CA | 90048 | NVITXI800 | 210768 | ||||||
Davita 4056 Los Angeles Downtown | 2021 South Flower Street | Los Angeles | CA | 90007 | 9BT2EC500 | 275793 | ||||||
Davita Century City Dialysis # 430 | 10630 Santa Xxxxxx Blvd | Los Angeles | CA | 90095 | 49FAXKJ00 | 276807 | ||||||
Davita Crescent Heights Dialysis | 8151 Xxxxxxx Blvd | Los Angeles | CA | 90048 | FG24G9Q00 | 276179 | ||||||
Davita Hollywood Dialysis Center | 5108 Sunset Boulevard | Los Angeles | CA | 90027 | 04DNX3400 | 233510 | ||||||
Davita Los Angeles Dialysis Center | 2250 S. Western Ave Suite 300 | Los Angeles | CA | 90018 | E10E0F800 | 208882 | ||||||
Davita Silver Lake Dialysis | 2723 X. Xxxxxx St. | Los Angeles | CA | 90026 | J0J3C9Q00 | 1662257 | ||||||
Xxxxxx Xxxxxxxxxx Plaza Dialysis Center | 516-522 East Washington Boulevard | Los Angeles | CA | 90015 | 6BN335F00 | 279025 | ||||||
Davita Wilshire Dialysis Center | 1212 Wilshire Blvd | Los Angeles | CA | 90017 | 90JTY8R00 | 210779 | ||||||
Davita Healthcare of Los Banos | 222 I. Street | Los Banos | CA | 93635 | XX0XXX000 | 226410 | ||||||
Davita Imperial Care, Dialysis Center #1523 | 4345 East Imperial Highway | Lynwood | CA | 90262 | X000XXX00 | 277257 | ||||||
Kidney Dialysis Care Units | 3600 East Xxxxxx Xxxxxx Xxxx, Junior Boulevard | Lynwood | CA | 90262 | KRQ7MD700 | 210897 | ||||||
Davita - Almond Wood Dialysis#2242 | 501 X. Xxxxxx Ave | Madera | CA | 93637 | 50PPJRT00 | 209044 | ||||||
Davita #2442 Yosemite | 1650 X. Xxxxxxxx Ave | Manteca | CA | 95337 | F27VLNR00 | 1449350 | ||||||
Davita 3802 Manteca | 1156 South Main Street | Manteca | CA | 95337 | UZDU41500 | 219624 | ||||||
Davita - Marysville Dialysis Center #2036 | 1015 Eighth Street | Marysville | CA | 95901 | FGCWXHH00 | 1112552 | ||||||
Davita 3143 Merced North | 3150 North G. Street, Suite A | Merced | CA | 95340 | 2NYMWMR00 | 210823 | ||||||
Xxxxxx Xxxxxx At Home | 3150 G. Street, Suite B. | Merced | CA | 95340 | G49WV5P00 | 1275816 |
Page 33 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita 2564 Mission Viejo | 27640 Marguerite Pkwy | Mission Viejo | CA | 92692 | BKG2C4T00 | 213242 | ||||||
Davita Montclair Dialysis Center | 5050 Palo Verde St. Ste 100 | Montclair | CA | 91763 | D7PP99G00 | 235096 | ||||||
Davita Doctors Dialysis Center of Montebello | 1721 West Whittier Boulevard | Montebello | CA | 90640 | 554J6EH00 | 232257 | ||||||
Xxxxxx Xxxxxxxx Hemodialysis Center | 118 Xxxxxxxx Avenue | Monterey Park | CA | 91754 | 9EMXV8900 | 210843 | ||||||
Xxxxxx Xxxxxxxx Pd #4375 | 228 X. Xxxxxxxx Ave Ste 301 | Monterey Park | CA | 91754 | 94V2MLH00 | 1695173 | ||||||
Davita Monterey Park Dialysis Center, Inc. | 2560 Corporate Pl Suite D100-102 | Monterey Park | CA | 91754 | 2D81JKR00 | 208885 | ||||||
Davita Canyon Springs Dialysis | 22555 Alessandro Blvd | Moreno Valley | CA | 92553 | 42KTMGL00 | 1436243 | ||||||
Davita Valley View Dialysis | 26900 Cactus Avenue | Moreno Valley | CA | 92555 | XXXXXXX00 | 227310 | ||||||
Xxxxxx Xxxxxxxxx Dialysis Center | 25100 Xxxxxxx Avenue, Suite 101-103 | Murrietta | CA | 92562 | 2652FJD00 | 224274 | ||||||
Davita - Napa Dialysis Center | 3900 - C Bel Aire Plaza | Napa | CA | 94558 | GMVQA6300 | 226989 | ||||||
Davita Norco Dialysis | 1901 Town and Country Dr Ste 100 | Norco | CA | 92860 | 81RDNVV00 | 1219477 | ||||||
Davita North Highlands Dialysis Center | 4986 Watt Avenue, Suite F. | North Highlands | CA | 95660 | GCRRYCK00 | 236041 | ||||||
Davita Healthcare of North Hollywood | 12126 Victory Blvd | North Hollywood | CA | 91606 | 2GLDFQL00 | 230686 | ||||||
Davita Norwalk Dialysis Center | 12375 Imperial Hwy Ste D3 | Norwalk | CA | 90650 | 0XXX00X00 | 216245 | ||||||
Davita 3818 Oakland | 5354 Claremont Ave | Oakland | CA | 94618 | K6K0QAA00 | 223895 | ||||||
Davita Alameda County | 10700 Xxxxxxxx Boulevard, Suite 14 | Oakland | CA | 94605 | T3YG8FX00 | 231981 | ||||||
Oakland Peritoneal Dialysis Center | 2633 Telegraph Avenue, Suite 115 | Oakland | CA | 94612 | 3A6BL0F00 | 275453 | ||||||
Davita Ontario Dialysis Center | 1950 Grove Avenue, Suite 101-105 | Ontario | CA | 91761 | 4J3B01200 | 1126073 | ||||||
Davita Main Place Dialysis | 972 Town and Country Rd | Orange | CA | 92868 | XXX00X000 | 235532 | ||||||
Orangevale Dialysis | 9267 Greenback Lane, Suite A-2 | Orangevale | CA | 95662 | H28DMA000 | 280414 | ||||||
Davita 3067 Palm Springs | 1061 North Indian Canyon Drive | Palm Springs | CA | 92262 | CH86HUI00 | 210865 | ||||||
Palmdale Regional Dialysis Center | 1643 Palmdale Boulevard | Palmdale | CA | 93550 | 1KGVJ8N00 | 306248 | ||||||
Davita - Paramount Dialysis Center | 8319 Alondra Boulevard | Paramount | CA | 90723 | SCYHC2X00 | 210759 | ||||||
Davita - Xxxxx Canyon Dialysis Center | 2551 East Washington Boulevard | Pasadena | CA | 91107 | P6H0BRE00 | 210796 | ||||||
Davita Pasadena Foothills Dialysis #4329 | 3722 E. Colorado Blvd | Pasadena | CA | 91107 | A346L5D00 | 1695101 | ||||||
Davita 3590 Penn Valley Home Training | 11374 Pleasant Valley Road | Penn Valley | CA | 95946 | KA8X2QR00 | 320528 | ||||||
Davita Delta View Dialysis #2453 | 1150 X. Xxxxxx Rd | Pittsburg | CA | 94565 | GKYBVAE00 | 1722254 | ||||||
Placerville Dialysis Center, Dba: Total Renal Care - Placerville | 3964 Missouri Flat Road, Suite J. | Placerville | CA | 95667 | 393XLKH00 | 213230 | ||||||
Total Renal Care - Pleasanton, Aka: Pleasanton Dialysis Center | 5720 Stoneridge Mall Road, Suites 140 and 160 | Pleasanton | CA | 94588 | DH8M4F700 | 227908 | ||||||
Davita #3004 Pomona | 2111 X. Xxxxx Ave | Pomona | CA | 91767 | GWPBYGQ00 | 210816 | ||||||
Davita Sunset Dialysis Center | 3071 Gold Canal Dr | Rancho Cordova | CA | 95670 | EC9DTAF00 | 1435974 | ||||||
Sunrise Dialysis Center, Dba: Total Renal Care - Sunrise | 2951 Sunrise Boulevard, Suite 145 | Rancho Cordova | CA | 95742 | R0Q8W0L00 | 231889 | ||||||
Davita Red Bluff Dialysis Center #2127 | 2455 Sister Xxxx Xxxxxxx Drive | Red Bluff | CA | 96080 | 0XXX0XX00 | 1203130 | ||||||
Davita 1015-1 Redding Acute Dialysis Services | 1876 Park Marina Dr | Redding | CA | 96001 | X00X0XX00 | 210876 | ||||||
Xxxxxx Xxxxxxx At Home | 1876 Park Marina Drive | Redding | CA | 96001 | 90YGWJ200 | 1219081 | ||||||
Davita #2217 | 1000 Xxxxxxxx St. | Redwood City | CA | 94063 | GKME1FG00 | 1692712 | ||||||
Davita - Redwood City At Home # 5929 | 1000 Xxxxxxxx St. | Redwood City | CA | 94063 | 0JYRYBH00 | 1701073 | ||||||
Indian Xxxxx Valley Dialysis Center | 212 South Richmond Road | Ridgecrest | CA | 93555 | AJG2ABW00 | 233611 | ||||||
Davita Magnolia West At Home | 11161 Magnolia Avenue, Suite B. | Riverside | CA | 92505 | 5DQG5MF00 | 1275954 | ||||||
Davita Magnolia West Dialysis Center | 11161 Magnolia Avenue | Riverside | CA | 92505 | F2126RH00 | 1220469 | ||||||
Davita Riverside Dialysis #6707 | 4361 Xxxxxx Street, Suite 100 | Riverside | CA | 92501 | T917ADX00 | 210872 | ||||||
Davita Alhambra Dialysis Center | 1315 Alhambra Boulevard, Suite 100 | Sacramento | CA | 95816 | GDTH4X400 | 213723 | ||||||
Davita Calvine Dialysis #5029 | 8243 X. Xxxxxxxx Blvd Ste C | Sacramento | CA | 95828 | 5GDP7WQ00 | 1703385 | ||||||
Davita Natomas Dialysis | 30 Goldenland Court, Building G. | Sacramento | CA | 95834 | F5XEA9E00 | 1218731 | ||||||
Davita University Dialysis Center | 777 Campus Commons Road, Suite 100 | Sacramento | CA | 95825 | D4G4Y2100 | 210874 | ||||||
Florin Dialysis Center - Total Renal Care | 7000 Stockton Blvd | Sacramento | CA | 95823 | K20Y56V00 | 281338 | ||||||
South Sacramento Dialysis Center, Dba: Total Renal Care - South Sacramento | 7000 Franklin Blvd Ste 880 | Sacramento | CA | 95823 | FYFNJ1Z00 | 210838 | ||||||
Davita - Salinas | 955 Xxxxxx Circle, Suite C | Salinas | CA | 93901 | CP5Q7WZ00 | 210806 | ||||||
Davita Citrus Valley Dialysis Center | 894 Xxxxx St. | San Bernardino | CA | 92408 | K7FPENW00 | 1116002 | ||||||
Davita- Citrus Valley At Home | 894 Xxxxx Street | San Bernardino | CA | 92408 | 52V6MA400 | 1282690 | ||||||
Mountain Vista Dialysis Center | 4041 University Pkwy | San Bernardino | CA | 92407 | 86MH2VE00 | 227012 | ||||||
Davita Rx #1685 | 1178 Cherry Ave | San Bruno | CA | 94066 | 48YXWBE00 | 1185323 | ||||||
Davita 3210 San Diego South | 995 Gateway Center Way Ste 101 | San Diego | CA | 92102 | B9CJV7H00 | 219734 | ||||||
Davita 3456 San Ysidro | 1445 30th Street, Suite A | San Diego | CA | 92154 | H098VD600 | 284925 | ||||||
Davita 3484 San Diego East | 292 Euclid Avenue, Suite 100 | San Diego | CA | 92114 | 4AFM5XH00 | 317805 | ||||||
Davita 3559 College Dialysis | 6535 University Ave | San Diego | CA | 92115 | 7K1BQG900 | 344715 | ||||||
Davita 3569 Carmel Mountain | 9850 Carmel Mountain Rd Ste A | San Diego | CA | 92129 | 3B65PT700 | 345210 | ||||||
Davita Dialysis 3488-5 San Diego Scripps Mercy Hospital-Acute | 4077 5th Ave | San Diego | CA | 92103 | XXXXX0X00 | 1458312 | ||||||
Davita 3830 San Francisco | 1499 Xxxxxxx St. | San Francisco | CA | 94115 | 0XX0XXX00 | 213587 | ||||||
Davita 3847 Chinatown San Xxxx | 636 Clay St. | San Francisco | CA | 94111 | RYVV98W00 | 230247 | ||||||
Davita 6286 San Francisco At Home | 1499 Xxxxxxx St. | San Francisco | CA | 94115 | J6G8NPP00 | 1422739 | ||||||
Davita #2199 Aborn Dialysis | 3162 X. Xxxxx Rd Ste 100 | San Jose | CA | 95148 | K1MM2MH00 | 1617077 | ||||||
Davita #2276 Corner House Dialysis | 2005 Naglee Ave | San Jose | CA | 95128 | A24H6EH00 | 1409957 | ||||||
Davita 2477 San Jose Hhd/Pd-Ca | 4400 Stevens Creek Blvd Suite 50 | San Jose | CA | 95129 | 656Y7BX00 | 1423129 | ||||||
Davita Dialysis Center Home | 4400 Stevens Creek Blvd Suite 50 | San Jose | CA | 95129 | 18WAWFQ00 | 1419153 | ||||||
Jaco Fishenfeld | 150 N. Jackson Ave | San Jose | CA | 95116 | 1608705 | |||||||
Davita 2560 San Juan Capistrano South | 31736 Rancho Viejo Road, Suite B. | San Juan Capistrano | CA | 92675 | TCX96GX00 | 210763 | ||||||
Davita - East Bay Peritoneal Dialysis | 13939 East 14th Street, Suite 110 | San Leandro | CA | 94578 | FA08YB600 | 223507 | ||||||
Davita San Leandro Dialysis #4485 | 15555 E. 14th St. Suite 520 | San Leandro | CA | 94578 | 1GVBBTR00 | 1612628 | ||||||
Davita Dialysis San Marcos #2261 | 2135 Montiel Rd Bldg B. | San Marcos | CA | 92069 | F1PDC1V00 | 1468265 | ||||||
Davita San Pablo | 14020 San Pablo Boulevard, Suite B. | San Pablo | CA | 94806 | ELHOVUT00 | 225071 | ||||||
Davita Northgate Dialysis Center #2296 | 650 Las Gallinas Ave | San Rafael | CA | 94903 | JJPPMHJ00 | 1454051 | ||||||
Davita Sanger Dialysis Center #2188 | 2517 Jensen Ave Bldg B. | Sanger | CA | 93657 | G7MXGVH00 | 1621208 | ||||||
Davita #2019 Tustin Dialysis Center | 2090 North Tustin Avenue | Santa Ana | CA | 92705 | K0J8JLF00 | 344531 | ||||||
Davita - Santa Ana Dialysis | 1820 East Deere Avenue | Santa Ana | CA | 92705 | XYL5BFB00 | 228033 | ||||||
Davita - Santa Monica Mar Vista | 2020 Santa Monica Boulevard, Suite 100 and 102 | Santa Monica | CA | 90404 | 3H8AYVV00 | 1229708 | ||||||
Davita 3211 Santa Monica | 1260 15th Street, Suite 102 | Santa Monica | CA | 90404 | 87B1EV000 | 210923 | ||||||
Davita Santa Paula Dialysis #5534 | 253 March St. | Santa Paula | CA | 93060 | CH2P92V00 | 235253 | ||||||
Davita # 4054-1 Selma Dialysis | 2711 Cinema Way Ste 111 | Selma | CA | 93662 | 00J9NXC00,53RA5Q400 | 230959 | ||||||
Davita Simi Valley At Home #5936 | 2950 Sycamore Dr Ste 100 | Simi Valley | CA | 93065 | J74RM3A00 | 1683049 | ||||||
Davita Simi Valley Dialysis #5533 | 2950 North Sycamore Drive, Suite 100-102 | Simi Valley | CA | 93065 | FDJVT7600 | 210772 | ||||||
Soledad Dialysis | 901 Los Coches Drive | Soledad | CA | 93960 | K0DF12F00 | 320727 | ||||||
Davita Westborough Dialysis Center #4424 | 925 El Camino Real | South San Francisco | CA | 94080 | K93596G00 | 1485894 | ||||||
Davita #1998 Stockton Kidney Center | 1523 E. March Ln Ste 200 | Stockton | CA | 95210 | 4J6HXAH00 | 1272975 | ||||||
Davita 3666 Stockton Home Training | 545 East Cleveland, Suite A | Stockton | CA | 95204 | 01WXDY500 | 1104727 | ||||||
Delta-Sierra Dialysis Center - Total Renal Care | 555 West Benjamin Holt Drive, Suite 200 | Stockton | CA | 95207 | 97YJ06300 | 232039 | ||||||
Davita - Temecula Dialysis | 40945 County Center Drive, Suite G. | Temecula | CA | 92591 | 89KFFWR00 | 226257 | ||||||
Davita Thousand Oaks At Home #5935 | 375 Rolling Oaks Dr Ste 100 | Thousand Oaks | CA | 91361 | C4TPDNY00 | 1683009 | ||||||
Davita Harbor-UCLA | 21602 South Vermont Avenue | Torrance | CA | 90502 | FGRD4GJ00 | 234932 | ||||||
Davita 3857 Tracy | 425 West Beverly Place, Suite A | Tracy | CA | 95376 | B8BTP5H00 | 235751 | ||||||
Davita 3298 Tulare | 545 East Tulare Avenue | Tulare | CA | 93274 | 89RXA2H00 | 213255 | ||||||
Davita - Turlock Dialysis Clinic | 50 W. Syracuse Ave | Turlock | CA | 95380 | AGLL5CD00 | 1096267 | ||||||
Davita 3328 Pear Tree Dialysis | 126 North Orchard Avenue | Ukiah | CA | 95482 | 92345TG00 | 275572 | ||||||
Davita-Union City At Home | 32930 Alvarado Niles Rd, Suite 300 | Union City | CA | 94587 | 268JGJY00 | 1283082 | ||||||
Total Renal Care Union City Dialysis Center | 32930 Alvarado Niles Road, Suite 300 | Union City | CA | 94587 | L93H9H400 | 227906 | ||||||
Davita 3903 Upland | 600 North 13th Avenue | Upland | CA | 91786 | 9K27UVR00 | 210854 | ||||||
Creekside Dialysis Center #2017 | 141 Parker Street | Vacaville | CA | 95688 | DKD2J7200 | 346966 | ||||||
Davita - Vacaville Dialysis Center | 941 Merchant St. | Vacaville | CA | 95688 | 60850SB00 | 226979 | ||||||
Davita #2123 Carquinez | 125 Corporate Pl Ste C | Vallejo | CA | 94590 | K5B9GYN00 | 1216206 | ||||||
Davita 3806 Vallejo | 121 Hospital Dr | Vallejo | CA | 94589 | VFOKUIU00 | 210840 | ||||||
Valley Dialysis Center | 16149 Hart Street | Van Nuys | CA | 91406 | 28Q6K6W00 | 210852 | ||||||
Davita Ventura Dialysis #5548 | 2705 Loma Vista Rd Ste 101 | Ventura | CA | 93003 | GD286MV00 | 1249624 | ||||||
Davita 3299 Tri Counties Home Training | 433 South Bridge Street | Visalia | CA | 93277 | 9T2J8JE00 | 209082 | ||||||
Davita 3300 Visalia | 1031 North Demaree | Visalia | CA | 93291 | BYAN1CJ00 | 208966 | ||||||
Davita Visalia At Home #5556 | 1120 N. Chinowth St. | Visalia | CA | 93291 | HKDEGHP00 | 232720 | ||||||
Davita Walnut Creek | 404 North Wiget Lane | Walnut Creek | CA | 94598 | 5FK4DK500 | 209042 | ||||||
Davita Walnut Creek At Home | 400 N. Wiget Ln | Walnut Creek | CA | 94598 | LHX0E7K00 | 1224227 | ||||||
Covina Dialysis Center | 1547 West Garvey Avenue | West Covina | CA | 91790 | L44BE6O00 | 210827 | ||||||
Davita - West Sacramento At Home | 3450 Industrial Blvd. #100 | West Sacramento | CA | 95691 | 97GTLY800 | 1401497 | ||||||
Davita- West Sacramento #2189 | 3450 Industrial Blvd Ste 100 | West Sacramento | CA | 95691 | G0CMKEC00 | 1282381 | ||||||
Davita Thousand Oaks Dialysis # 5532 | 375 Rolling Oaks Dr Ste 100 | Westlake Village | CA | 91361 | L19RQV700 | 316114 |
Page 34 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita Westminster South # 3545 | 14014 Magnolia St. | Westminster | CA | 92683 | E5T5W9M00 | 230545 | ||||||
Davita Santa Fe Springs #2260 | 11147 Washington Blvd | Whittier | CA | 90606 | 385P30800 | 1279585 | ||||||
Davita Whittier Dialysis Center | 10055 Whittwood Drive | Whittier | CA | 90603 | 35GVL5900 | 210815 | ||||||
Davita #0291 Yuba City | 1525 Plumas Court, Suite A | Yuba City | CA | 95991 | 61JCVTQ00 | 210844 | ||||||
Davita Yucaipa Dialysis | 33487 Yucaipa Boulevard | Yucaipa | CA | 92399 | GAA8VAD00 | 1246420 | ||||||
Davita 2568 High Desert | 58457 29 Palms Building 100, Suite 102, Highway 1 | Yucca Valley | CA | 92284 | 7Y4Q62700 | 232633 | ||||||
Davita Alamosa Dialysis Center | 612 Del Sol Drive | Alamosa | CO | 81101 | 5DL2V2200 | 1161141 | ||||||
Davita Arvada Dialysis | 9950 West 80th, Suite 25 | Arvada | CO | 80005 | 1BDT9NE00 | 231710 | ||||||
Davita - Aurora Dialysis | 1411 S. Potomac St. Ste 100 | Aurora | CO | 80012 | T9X6KLA00 | 228696 | ||||||
Davita Dialysis - East Aurora | 482 South Chambers Road | Aurora | CO | 80017 | ABF72KT00 | 318370 | ||||||
Davita - Boulder Dialysis Center | 2880 Folsom Street, Suite 110 | Boulder | CO | 80304 | YUXPFA300 | 213260 | ||||||
Brighton Dialysis Center #2067 | 4700 East Bromley Lane, Suite 103 | Brighton | CO | 80601 | 566WBE200 | 1088734 | ||||||
Davita - North Colorado Springs At Home Dialysis #5973 | 6071 E. Woodmen Rd Suite 100/120 | Colorado Springs | CO | 80923 | K424QBV00 | 1467820 | ||||||
Davita Pikes Peak At Home | 2002 Lelaray Street, Suite 130 | Colorado Springs | CO | 80909 | 7B68N0J00 | 1229597 | ||||||
Davita Pikes Peak Dialysis Center | 2002 Le Leray Street, Suite 130 | Colorado Springs | CO | 80909 | B4RVWA700 | 210723 | ||||||
Davita Printer’s Place Dialysis Center | 2802 International Cir | Colorado Springs | CO | 80910 | 9757RRA00 | 234849 | ||||||
Davita- North Colorado Springs Dialysis Center # 4367 | 6071 E. Woodmen Rd Suite 100/120 | Colorado Springs | CO | 80923 | B40X73M00 | 1464250 | ||||||
Davita Commerce City Dialysis | 6320 Holly St. | Commerce City | CO | 80022 | 5GYJX3200 | 281662 | ||||||
Da Vita - Cortez Dialysis | 610 East Main Street, Suite C | Cortez | CO | 81321 | JL06QBB00 | 275567 | ||||||
Davita - Belcaro Dialysis Center #2063 | 755 S. Colorado Blvd | Denver | CO | 80246 | AH7QC7700 | 1112573 | ||||||
Davita - Denver Dialysis | 2900 Downing Street, Suite C | Denver | CO | 80205 | 0KDMTMY00 | 228756 | ||||||
Davita - Thornton Dialysis Center | 8800 Fox Drive | Denver | CO | 80260 | 8HTYKFF00 | 209050 | ||||||
Davita 1869 Lowry Pd | 7465 East First Avenue, Suite A | Denver | CO | 80230 | 84HMQLQ00 | 1259694 | ||||||
Davita 2493 North Metro Dialysis Center | 12365 Huron St. Ste 500 | Denver | CO | 80234 | 0GNWPPD00 | 1428907 | ||||||
Davita Dialysis - Lowry At Home | 7465 East 1st Avenue, Suite 100 | Denver | CO | 80230 | A2J0386F1 | 1203666 | ||||||
Davita Dialysis 1063-4 Rose Medical Center-Acute | 4567 E. 9th Ave | Denver | CO | 80220 | 90FDBJV00 | 1463574 | ||||||
Davita Lowry Dialysis Center | 7465 E. 1st Ave Ste A | Denver | CO | 80230 | A2J038600 | 275948 | ||||||
Davita North Metro At Home Dialysis # 5979 | 12365 Huron St. Ste 500 | Denver | CO | 80234 | JDWRQBK00 | 1468185 | ||||||
Davita South Denver Dialysis | 850 East Harvard Avenue, Suite 60 | Denver | CO | 80210 | K9P75NH00 | 228757 | ||||||
Durango Dialysis Center #2109 | 72 Suttle Street, Unit D | Durango | CO | 81301 | AHJ7AKB00 | 1138380 | ||||||
Davita Englewood Dialysis | 3247 South Lincoln Street | Englewood | CO | 80113 | 8H1FQA500 | 277540 | ||||||
Davita Lonetree Dialysis Center | 9777 Mount Pyramid Court, Suite 140 | Englewood | CO | 80112 | D9MB0K300 | 1112572 | ||||||
Davita Dialysis - Fountain | 6910 Bandley Drive | Fountain | CO | 80817 | 97NHCGC00 | 1199226 | ||||||
Davita Grand Junction | 710 Wellington Avenue, Suite 20 | Grand Junction | CO | 81501 | B06GMK300 | 1224141 | ||||||
Davita Mesa County At Home #5940 | 561 25 Rd Ste D | Grand Junction | CO | 81505 | 5B8MC4Q00 | 1647679 | ||||||
Davita Mesa County Dialysis # 4489 | 561 25 Rd Ste D | Grand Junction | CO | 81505 | GG6DT4C00 | 1624753 | ||||||
Davita # 0541 Lakewood Dialysis Center | 1750 Pierce St. Suite B. | Lakewood | CO | 80214 | 38DJDEY00 | 210725 | ||||||
Davita Dialysis - Lakewood At Home | 1750 Pierce Street, Suite A | Lakewood | CO | 80214 | F0RXRPJ00 | 345825 | ||||||
Davita Lakewood Crossing Dialysis | 1057 S. Wadsworth Blvd Ste 100 | Lakewood | CO | 80226 | 7FQTY6900 | 284522 | ||||||
Davita - Littleton | 209 West County Line Road | Littleton | CO | 80129 | GP7HD6C00 | 228768 | ||||||
Da Vita Longmont Dialysis | 1715 Kylie Dr Suite 170 | Longmont | CO | 80501 | D8GMYAV00 | 281992 | ||||||
Davita Black Canyon #4490 | 3421 Rio Grande Unit D | Montrose | CO | 81401 | K5NDYNA00 | 1699215 | ||||||
Davita #2441 Dialysis Parker | 10371 S. Park Glenn Way Ste 180 | Parker | CO | 80138 | E6WEC8E00 | 1473079 | ||||||
Davita - Parker At Home # 5968 Dialysis | 10371 S. Park Glenn Way Ste 18 | Parker | CO | 80138 | FG4094C00 | 1473133 | ||||||
Davita - Westminster Dialysis Center | 9053 Harland St. Unit 90 | Westminster | CO | 80031 | ABWB75400 | 228697 | ||||||
Davita 3643 Bloomfield | 29 Griffin Road South | Bloomfield | CT | 6002 | E9Y0CNK00 | 346612 | ||||||
Davita 3385 Branford | 249 West Main Street | Branford | CT | 6405 | 18YDQ6G00 | 280942 | ||||||
Davita # 2501 Bridgeport | 900 Madison Ave | Bridgeport | CT | 6606 | TWGM5A600 | 219819 | ||||||
Davita - Bridgeport At Home | 900 Madison Ave Flr 2nd | Bridgeport | CT | 6606 | 414A6C100 | 1259862 | ||||||
Davita - Black Rock Dialysis #4332 | 427 Stillson Rd | Fairfield | CT | 6824 | 534ATGV00 | 1458684 | ||||||
Davita 2524 Hartford North | 675 Tower Ave Fl 2 | Hartford | CT | 6112 | FD61NXJ00 | 280827 | ||||||
Physician Dialysis Inc. - Middlesex Dialysis | 100 Riverview Center, Suite 11 | Middletown | CT | 6457 | DB8C24E00 | 282275 | ||||||
Davita 3389 Milford | 470 Bridgeport Ave | Milford | CT | 6460 | DBK6T5C00 | 278538 | ||||||
Davita 3043 New Haven | 100 Church Street South, Suite C | New Haven | CT | 6519 | BC3RAF600 | 226484 | ||||||
Davita-New Haven At Home | 100 Church Street S, Suite C | New Haven | CT | 6519 | 40R5D0D00 | 1282827 | ||||||
Davita 3254 New London Jv | 5 Shaws Cove, Suite 100 | New London | CT | 6320 | 7A40KY300 | 280531 | ||||||
Davita Windham Dialysis | 375 Tuckie Road, Suite C | North Windham | CT | 6256 | 1A9N6N000 | 1233114 | ||||||
Davita 3422 Norwalk | 31 Stevens Street | Norwalk | CT | 6850 | 30HNT0000 | 231711 | ||||||
Davita Norwich Jv | 113 Salem Turnpike | Norwich | CT | 6360 | 25CVMDD00 | 281204 | ||||||
Davita-Pdi-Rocky Hill At Home | 30 Waterchase Dr | Rocky Hill | CT | 6067 | 6AQ37YE00 | 1282826 | ||||||
Physician Dialysis Inc. - Rocky Hill Dialysis | 30 Waterchase Drive | Rocky Hill | CT | 6067 | G6YR2V800 | 281611 | ||||||
Davita 2506 Shelton Dialysis | 750 Bridgeport Ave | Shelton | CT | 6484 | E51LKLA00 | 229775 | ||||||
Davita - Stamford At Home | 30 Commerce Rd | Stamford | CT | 6902 | H7GJ51T00 | 1220455 | ||||||
Davita 3342 Stamford | 30 Commerce Road | Stamford | CT | 6902 | H44QALA00 | 210702 | ||||||
Davita 3639 Torrington | 780 Litchfield Street, Suite 100 | Torrington | CT | 6790 | 157TM3V00 | 285274 | ||||||
Davita Vernon Dialysis | 460 Hartford Turnpike | Vernon | CT | 6066 | KJQJG8000 | 1233110 | ||||||
Davita - Heights Dialysis Center | 150 Mattatuck Heights Road | Waterbury | CT | 6705 | 93EL2KX00 | 1400611 | ||||||
Davita 2503 Greater Waterbury | 209 Highland Ave | Waterbury | CT | 6708 | 5DPGK4B00 | 230091 | ||||||
Davita #3074 | 2131 K Street Northwest | Washington | DC | 20037 | FAEYH9R00 | 230084 | ||||||
Davita - Georgetown On the Potomac At Home | 3223 K Street Northwest, Suite 110 | Washington | DC | 20007 | C3CJ6FV00 | 1220453 | ||||||
Davita - Grant Park Dialysis | 5000 Nannie Helens Burroughs Avenue, Northeast | Washington | DC | 20019 | 11KUCTL00 | 210684 | ||||||
Davita 3075 George Washington | 3857 Pennsylvania Ave Se, Suite A | Washington | DC | 20020 | CCXYRFP00 | 230083 | ||||||
Davita 3707 Brentwood | 1231 Brentwood Northeast | Washington | DC | 20018 | 2NYXA4Y00 | 229675 | ||||||
Davita 3714 Eight Street | 300 8th St. Ne | Washington | DC | 20002 | MFDI2YW00 | 213266 | ||||||
Davita Dialysis | 810 1st St. Ne Ste 100 | Washington | DC | 20002 | C9WD6EE00 | 233683 | ||||||
Davita Washington Nursing Facility # 2465 Dialysis | 2425 25th St. Se | Washington | DC | 20020 | 14NWGTX00 | 1497085 | ||||||
Georgetown On the Potomac Dialysis Center | 3223 K Street Northwest, Suite 110 | Washington | DC | 20007 | 330060C00 | 213570 | ||||||
Lee Street Dialysis | 5155 Lee Street Northeast | Washington | DC | 20019 | A5N4LA100 | 278568 | ||||||
Davita - Apopka Dialysis Center # 1990 | 640 Executive Park Ct | Apopka | FL | 32703 | 34E3AXV00 | 1189183 | ||||||
Arcadia Dialysis Center | 1341 East Oak Street | Arcadia | FL | 34266 | 996FTA600 | 278233 | ||||||
Davita #2380 Ave Maria Dialysis Center | 5340 Useppa Dr | Ave Maria | FL | 34142 | G2Y6WDV00 | 1647750 | ||||||
Davita 4069 Bartow | 1190 East Church Street | Bartow | FL | 33830 | JLJMECZ00 | 208997 | ||||||
Boca Raton Artificial Kidney Center | 998 Northwest 9th Court | Boca Raton | FL | 33486 | IZ02DD900 | 210645 | ||||||
Davita- Pinnacle Dialysis of Boca Raton | 2900 N. Military Trl Ste 195 | Boca Raton | FL | 33431 | X21FLYY00 | 223511 | ||||||
Davita 4075 Bonita Springs Dialysis | 9134 Bonita Beach Rd Se | Bonita Springs | FL | 34135 | FFX3X2T00 | 277489 | ||||||
Davita - Bradenton At Home | 3501 Cortez Road West, Suite 104 | Bradenton | FL | 34210 | KDL5CED00 | 1288818 | ||||||
Davita 4038 Bradenton | 3501 Cortez Road West, Suite 104 | Bradenton | FL | 34210 | 8K9DMKK00 | 221205 | ||||||
Davita 2511 Brandon East | 114 East Brandon Boulevard | Brandon | FL | 33511 | 47Q3WKK00 | 286044 | ||||||
Davita | 1315 Southeast 8th Terrace | Cape Coral | FL | 33990 | 49VQ3WX00 | 210594 | ||||||
Davita-Cape Coral South | 3046 Del Prado Boulevard, Unit #4a | Cape Coral | FL | 33904 | J6FDB8000 | 1219188 | ||||||
Davita - Casselberry Dialysis Center # 1991 | 4970 S. Us Highway 17/92 | Casselberry | FL | 32707 | H91QGQN00 | 1273174 | ||||||
Davita Celebration Dialysis Center | 1154 Celebration Boulevard | Celebration | FL | 34747 | A4R492K00 | 277654 | ||||||
Davita #1750 Community Dialysis Center - Chipley | 877 3rd St. Ste 2 | Chipley | FL | 32428 | GJWETRT00 | 284903 | ||||||
Davita #0405 Ocala Regional Kidney Center-North | 2620 West Highway 316 | Citra | FL | 32113 | B887CFP00 | 320534 | ||||||
Davita Embassy Lake Artifical Kidney Center #2114 | 11011 Sheridan St. Ste 308 | Cooper City | FL | 33026 | E50222P00 | 1137900 | ||||||
Davita-Coral Gables Kidney Dialysis Center # 356 | 3280 Ponce De Leon Blvd | Coral Gables | FL | 33134 | 844EC8E00 | 210593 | ||||||
Davita Complete Care North At Home | 7850 West Sample Road | Coral Springs | FL | 33065 | 568WNRT00 | 1270143 | ||||||
Davita Complete Dialysis Care | 7850 West Sample Road | Coral Springs | FL | 33065 | C4MG1Q900 | 219611 | ||||||
Wsdc - North Okaloosa Dialysis | 320 West Redstone | Crestview | FL | 32536 | 7LMQHCX00 | 280556 | ||||||
Crystal River Dialysis Center | 7435 West Gulf To Lake Highway | Crystal River | FL | 34429 | GACV8RW00 | 233797 | ||||||
Davita Crystal River At Home | 7435 W. Gulf To Lake Highway | Crystal River | FL | 34429 | GET3BWX00 | 1279372 | ||||||
Davita Davenport Dialysis Center #2130 | 45597 Us Highway 27 | Davenport | FL | 33897 | DAW65VP00 | 1126131 | ||||||
Davita | 578 Healthwell Blvd | Daytona Beach | FL | 32114 | A6WB5YQ00 | 210644 | ||||||
Davita Daytona Beach At Home #6324 | 578 Health Blvd | Daytona Beach | FL | 32114 | CK9758P00 | 1683012 | ||||||
Davita Deerfield Beach | 1983 West Hillsboro Boulevard | Deerfield Beach | FL | 33442 | VM7M6BR00 | 227956 | ||||||
Davita 4339 Defuniak Springs Dialysis Center | 1045 Us Highway 331 S. | Defuniak Springs | FL | 32435 | 9FQCR4L00 | 1463882 | ||||||
Davita - Deland Dialysis # 4039 | 350 E. New York Ave | Deland | FL | 32724 | 452N4AC00 | 1364179 | ||||||
Davita North Delray | 2655 W. Atlantic Ave | Delray Beach | FL | 33445 | LJYJEYX00 | 208971 | ||||||
Davita Gulf Breeze Dialysis | 1519 Main St. | Dunedin | FL | 34698 | 3LG3W8B00,8F9YCLR00 | 231411 | ||||||
Davita Amelia Island Dialysis | 1525 Lime Street, Suite 120 | Fernandina Beach | FL | 32034 | DERQK3V00 | 277256 | ||||||
Davita East Fort Lauderdale Dialysis Center #2031 | 1301 South Andrews Avenue, Suite 101 | Fort Lauderdale | FL | 33316 | 04BB70X00 | 1080255 |
Page 35 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita-North Broward Acutes #4051 Dialysis | 1500 N. Federal Hwy Ste 100 | Fort Lauderdale | FL | 33304 | 8R9EPOZ00 | 210615 | ||||||
Fort Lauderdale Renal Associates, Inc. | 6264 North Federal Highway | Fort Lauderdale | FL | 33308 | 48MEGXP00 | 209351 | ||||||
Davita 3551 Fort Myers North | 16101 North Cleveland Avenue | Fort Myers | FL | 33903 | 0JPFEFG00 | 315124 | ||||||
Davita 4043 Fort Myers South | 8570 Granite Ct | Fort Myers | FL | 33908 | G7LG0K800 | 276325 | ||||||
Davita Fort Myers | 2133 Winkler Ave | Fort Myers | FL | 33901 | 74L86MW00 | 224036 | ||||||
Davita Fort Pierce | 1801 S. 23rd St. Ste 1 | Fort Pierce | FL | 34950 | 8HECF1V00 | 280820 | ||||||
Davita 2091 Aventura Dialysis Center | 22 Sw 11th St. Floor 2 | Hallandale Beach | FL | 33009 | 48AXYTA00 | 1454086 | ||||||
Davita #0354 Flamingo Pk | 901 E. 10th Ave Ste 17 | Hialeah | FL | 33010 | 9FLRE1F00 | 226385 | ||||||
Davita -Hialeah Artificial Kidney Center | 2750 W. 68th St. Ste 207 | Hialeah | FL | 33016 | 9JM00DR00 | 1199877 | ||||||
Davita #0260 | 4401 Hollywood Blvd | Hollywood | FL | 33021 | O0B8OC700 | 210661 | ||||||
Bayonet Point - Hudson Kidney Center | 14144 Nephron Lane | Hudson | FL | 34667 | RYU831V00 | 210608 | ||||||
Davita #4389 Jacksonville South | 14965 Old St. Augstine Rd, Suite 114 | Jacksonville | FL | 32258 | BDFT2XV00 | 1473162 | ||||||
Davita - Regency At Home #6188 | 9535 Regency Square Blvd | Jacksonville | FL | 32225 | HF03VTN00 | 1283200 | ||||||
Davita - Regency Dialysis #2274 | 9535 Regency Square Blvd. | Jacksonville | FL | 32225 | 1F1B4VR00 | 1279763 | ||||||
Davita | 802 N. John Young Pkwy | Kissimmee | FL | 34741 | J5413PL00 | 210602 | ||||||
Ocala Regional Kidney - South Unit | 13940 Us Highway 441 | Lady Lake | FL | 32159 | 5FT0HPJ00 | 275219 | ||||||
Davita 4017 Lake Wales | 1125 Bryn Mawr Ave | Lake Wales | FL | 33853 | 47QPHCJ00 | 233247 | ||||||
Davita 4024 Lakeland | 515 East Bella Vista | Lakeland | FL | 33805 | FUN9Z9D00 | 210641 | ||||||
Davita 4071 Lakeland South | 5050 S. Florida Ave Ste 1 | Lakeland | FL | 33813 | 9973X2R00 | 280517 | ||||||
Davita Lakeland South At Home #6278 | 5050 S. Florida Ave Ste 1 | Lakeland | FL | 33813 | AA4GLLA00 | 1728234 | ||||||
Bay Breeze Dialysis | 11465 Ulmerton Road | Largo | FL | 33778 | L9E80M200 | 276604 | ||||||
Davita - Leesburg Dialysis | 801 East Dixie Avenue, Suite 108-A | Leesburg | FL | 34748 | 71F5WI600 | 228587 | ||||||
Davita Lake Griffin East Dialysis | 401 E. North Blvd | Leesburg | FL | 34748 | 5705BA200 | 1161431 | ||||||
Lake Dialysis | 221 North First Street | Leesburg | FL | 34748 | AKK7EGF00 | 232512 | ||||||
Davita 4009 Lehigh Acres | 2719 Fourth Street West | Lehigh Acres | FL | 33971 | 62PWE1800 | 225109 | ||||||
Davita Gateway Dialysis Center #4417 | 5705 Lee Blvd | Lehigh Acres | FL | 33971 | 4B04MEJ00 | 1634753 | ||||||
Davita Four Freedoms Dialysis | 289a Southwest Range Avenue | Madison | FL | 32340 | 54E1QM000 | 275146 | ||||||
Davita Marianna Dialysis Center | 2930 Optimist Dr | Marianna | FL | 32448 | Y5BCDY100 | 227123 | ||||||
Davita 3655 Melbourne-Fka Brevard County | 2235 South Babcock Street | Melbourne | FL | 32901 | GC2JTPV00 | 1137902 | ||||||
Davita #0351 Center for Kidney Disease | 1190 Northwest 95th Street, Suite 208 | Miami | FL | 33150 | G6KG56X00,JNUYFXA00 | 210588 | ||||||
Davita 3460 Miami East | 1250 Nw 7th St. Ste 106 | Miami | FL | 33125 | K41K22D00 | 287122 | ||||||
Davita Florida Renal | 3500 Northwest 7th Street | Miami | FL | 33125 | HAMA2G500 | 1220683 | ||||||
Davita Greater Miami | 160 Nw 176th St. Ste 100 | Miami | FL | 33169 | KKGNPFB00 | 210585 | ||||||
Davita Kendall Dialysis #4409 | 8364 Mills Dr Ste 1740 | Miami | FL | 33183 | F7RKMAT00 | 1722941 | ||||||
Davita Miami | 1500 Nw 12th Ave Ste 106 | Miami | FL | 33136 | 8DV2EKG00,ROKKX8O00 | 221974 | ||||||
Davita Miami Campus Acutes #6323 Dialysis | 1500 Nw 12th Ave Ste 106 | Miami | FL | 33136 | 9GBY48A00 | 1496579 | ||||||
Interamerican Dialysis Institute, Inc. | 7815 Coral Way, Suite 119 | Miami | FL | 33155 | S9JTXIS00 | 210635 | ||||||
Davita South Beach | 4701 North Meridian Avenue | Miami Beach | FL | 33140 | 82KE3KV00 | 1157886 | ||||||
Davita Miami Gardens | 3363 Northwest 167th Street | Miami Gardens | FL | 33056 | 4GAKXKV00 | 1215701 | ||||||
Davita - Miami Lakes Artifical Kidney Center | 14600 60th Avenue Northwest | Miami Lakes | FL | 33014 | WRELVK100 | 221297 | ||||||
Davita Santa Rosa At Home | 5819 Highway 90 | Milton | FL | 32583 | AJ9HPFN00 | 1233136 | ||||||
Santa Rosa Dialysis | 5819 Highway 90 | Milton | FL | 32583 | 8J4FMKG00 | 235520 | ||||||
Davita Miramar Dialysis Center | 2501 Dykes Rd Ste 200 | Miramar | FL | 33010 | 0B3P0AD00 | 1453700 | ||||||
Mount Dora Dialysis | 2735 West Old U.S. Highway 441 | Mount Dora | FL | 32757 | 4GGG73Q00 | 213288 | ||||||
Davita 4074 Naples | 661 9th Street North | Naples | FL | 34102 | B4EBLWL00 | 279196 | ||||||
Davita Naples At Home Dialysis #4074 | 661 9th Street North | Naples | FL | 34102 | FFK3E7200 | 1275789 | ||||||
Davita Dialysis - New Smyrna Beach #4014 | 110 South Orange Avenue | New Smyrna Beach | FL | 32168 | LFFB42W00 | 231975 | ||||||
Davita Greater Miami At Home | 160 Nw 176 Street, Suite 100 | North Miami | FL | 33169 | VDRN02O00 | 1269982 | ||||||
Davita Miami North Dialysis | 860 Ne 125th St. | North Miami | FL | 33161 | BBQL89E00 | 281747 | ||||||
Venture Dialysis Center, Inc. | 16855 Northeast 2nd Avenue, Suite 205 | North Miami Beach | FL | 33162 | JTYKT2P00 | 213290 | ||||||
Davita Palm Breeze Dialysis Center # 4492 | 14942 Tamiami Trl | North Port | FL | 34287 | 660E5FA00 | 1623922 | ||||||
Davita Advanced Dialysis Center of Fort Lauderdale # 5589 | 911 E. Oakland Park Blvd | Oakland Park | FL | 33334 | 1BBFTYT00 | 1486636 | ||||||
Davita # 0402 Ocala Regional Kidney Center - East | 2870 Southeast 1st Avenue | Ocala | FL | 34471 | 96JW4DB00 | 231423 | ||||||
Davita #0403 Ocala Regional Kidney Center - West | 9401 Southwest Highway 200, Building 600, Suite 601 | Ocala | FL | 34481 | 2XW8PJB00 | 230685 | ||||||
Davita - Ocala At Home | 2860 South East First Street | Ocala | FL | 34471 | 0CGVEMN00 | 1283112 | ||||||
Davita Ocala Regional Home Division | 2860 Southeast 1st Avenue | Ocala | FL | 34471 | FADH9YQ00 | 1161292 | ||||||
Davita 3044 Ocoee | 11140 W. Colonial Dr Ste 5 | Ocoee | FL | 34761 | 992016R00 | 214069 | ||||||
Davita - Orange City | 242 Treemonte Dr | Orange City | FL | 32763 | F9Q1PNR00 | 284911 | ||||||
Davita 3021 Orlando Downtown | 116 Sturtevant St. | Orlando | FL | 32806 | AQVTUL300 | 213294 | ||||||
Davita 3208 Orlando North-Adanson | 5135 Adanson Street, Adanson Center, Suite 700 | Orlando | FL | 32804 | B3HA1GM00 | 232803 | ||||||
Davita 3351 Orlando East Semoran Blvd | 1160 S. Semoran Blvd Ste C | Orlando | FL | 32807 | 8HCHHML00 | 225974 | ||||||
Davita 3481 Orlando Home Training Dialysis | 116 Sturtevant St. Ste 2 | Orlando | FL | 32806 | 29VR7GK00 | 1624058 | ||||||
Davita 4076 Orlando Southwest | 6925 Lake Ellenor Dr | Orlando | FL | 32809 | DE6PWK200 | 277105 | ||||||
Davita Orlando Hemo Dialysis #0178 | 14050 Town Loop Blvd Ste 104a | Orlando | FL | 32837 | CAPJT8V00 | 276120 | ||||||
Davita Orlando Park Dialysis Center #4446 | 5397 W. Colonial Dr Suite 120 | Orlando | FL | 32808 | 61AVWLT00 | 1608967 | ||||||
Davita Rx | 2616 Commerce Dr Ste 500b | Orlando | FL | 32819 | D9NDKQW00 | 1188992 | ||||||
Davita-Central Orlando Dialysis Center # 1992 | 2548 North Orange Blossom Trail, Suite 400 | Orlando | FL | 32804 | DA1J32C00 | 1196766 | ||||||
Orlando Home Training #3481 | 3885 Oakwater Cir Suite C | Orlando | FL | 32806 | L2TXCPE00 | 281060 | ||||||
Davita 4070 Ormond Beach | 495 S. Nova Rd Ste 109 | Ormond Beach | FL | 32174 | YDRL18W00 | 213667 | ||||||
North Palm Beach Dialysis Center, Inc. | 3375 Burns Road, Suite 101 | Palm Beach Gardens | FL | 33410 | 2V2I0P600 | 213295 | ||||||
Davita 4042 Palm Coast | 13 Kingswood Dr Ste A | Palm Coast | FL | 32137 | ADGBQFJ00 | 236070 | ||||||
Davita of Lake Worth | 2459 S. Congress Ave Ste 100 | Palm Springs | FL | 33406 | 187DDBH00 | 213827 | ||||||
Davita - Panama City Dialysis | 615 Highway 231 | Panama City | FL | 32405 | 29W24R400 | 210651 | ||||||
Davita 2338 West Beach Dialysis | 16201 Panama City Beach Pkwy Ste 102 | Panama City | FL | 32413 | 787N15F00 | 1405146 | ||||||
Davita Coastal Kidney Center #1612 | 510 N. Macarthur Ave | Panama City | FL | 32401 | 1H3J8MY00 | 1121088 | ||||||
Davita Panama City At Home #5926 | 615 N. Highway 231 | Panama City | FL | 32405 | GDEB81R00 | 1724031 | ||||||
Davita - West Florida Hospital # 1068-9 Dialysis | 8333 N. Davis Hwy | Pensacola | FL | 32514 | EJEF61X00 | 210647 | ||||||
Davita Panhandle Alabama Acutes Dialysis # 1075-4 | 7835 N. Davis Hwy | Pensacola | FL | 32514 | 17QBPRP00 | 1468231 | ||||||
Davita West Pensacola At Home #6187 | 598 N. Fairfield Drive, Suite 100 | Pensacola | FL | 32506 | H50LP1X00 | 1279374 | ||||||
Davita West Pensacola Dialysis #2305 | 598 N. Fairfield Dr Ste 100 | Pensacola | FL | 32506 | 1FP9MJJ00 | 1272807 | ||||||
Davita 3508 Perry | 118 West Main Street | Perry | FL | 32347 | J6L1V9F00,J6L1V9FF0 | 312395 | ||||||
Davita 4029 Plant City | 1211 West Reynolds Street, Suite 1 | Plant City | FL | 33563 | QD9QXON00 | 210616 | ||||||
Davita | 7061 Cypress Rd Ste 103 | Plantation | FL | 33317 | B3U8MKM00 | 208992 | ||||||
Pine Island Kidney Center | 1871 North Pine Island Road | Plantation | FL | 33322 | 47K17BE00 | 232723 | ||||||
Davita - Pompano Beach Artificial Kidney Center | 1311 East Atlantic Boulevard | Pompano Beach | FL | 33060 | 53RAM2X00 | 209346 | ||||||
Davita - Port Charlotte Artificial Kidney Center | 4300 Kings Highway, Suite 406, Box D17 | Port Charlotte | FL | 33980 | H2NMWQE00 | 210621 | ||||||
Gulf Coast Dialysis, Inc. | 3300 Tamiami Trail, Suite 101a | Port Charlotte | FL | 33952 | FY36RLY00 | 213582 | ||||||
Davita-New Port Richey Kidney Center | 7421 Ridge Road | Port Richey | FL | 34668 | C4QFJNR00 | 209338 | ||||||
Davita 2825-1 Liberty | 10400 South Federal Highway, Suite 100 | Port St. Lucie | FL | 34952 | GCHTWDB00 | 1157913 | ||||||
Davita 4088 Quincy | 878 Strong Rd | Quincy | FL | 32351 | EAGWLXI00 | 208996 | ||||||
Davita 4064 Sun City Center | 775 Cortaro Dr | Ruskin | FL | 33573 | 4RAKCIJ00 | 213832 | ||||||
Davita-Sanford Dialysis Center #1993 | 1701 West 1st Street | Sanford | FL | 32771 | 169EQM600 | 1181147 | ||||||
Davita 3275 Sebastian | 1424 Us Highway 1 Ste C | Sebastian | FL | 32958 | CD4YJ6G00 | 235859 | ||||||
Davita- Daytona Beach South # 4002 Dialysis | 1801 S. Nova Rd Ste 306 | South Daytona | FL | 32119 | C9A6V1X00,FM331PX00 | 209342 | ||||||
Hernando Kidney Center | 2985-A Landover Boulevard | Spring Hill | FL | 34608 | 8CLKKAJ00 | 209343 | ||||||
Davita St. Cloud Dialysis | 4750 Old Canoe Creek Rd | St. Cloud | FL | 34769 | LK4X3KT00 | 1279758 | ||||||
Davita 3447 St. Petersburg | 1117 Arlington Ave N. | St. Petersburg | FL | 33705 | 6HQBYJ500 | 282131 | ||||||
Davita Dialysis - Bayfront Medical Center | 701 6th St. S,6 N. Dialysis Unit | St. Petersburg | FL | 33701 | EL1H73R00 | 1454088 | ||||||
Davita Pinellas Dialysis Center #4407 | 3451 66th St. N. | St. Petersburg | FL | 33710 | 4BRJ0QF00 | 1644353 | ||||||
Davita St. Petersburg At Home | 2850 34th Street South | St. Petersburg | FL | 33711 | 9BVTC2M00 | 1273173 | ||||||
Davita St. Petersburg South | 2850 34th Street South | St. Petersburg | FL | 33711 | 0D48XG200 | 1080305 | ||||||
Davita - West Tennessee At Home/Pd | 2645 West Tennessee, Suite 14 | Tallahassee | FL | 32304 | 229P44A00 | 1289319 | ||||||
Davita 4001 Tallahassee West | 2645 West Tennessee, Suite 8 | Tallahassee | FL | 32304 | 5HVNEWE00 | 228966 | ||||||
Davita 4089 Tallahassee | 1607 Physicians Dr | Tallahassee | FL | 32308 | X9UL0G100 | 208995 | ||||||
Davita South | 2410 S. Adams St. | Tallahassee | FL | 32301 | GE9VTG700 | 280799 | ||||||
Davita - Tamarac Artificial Kidney Center #177 | 7140-7148 West Mcnab Road | Tamarac | FL | 33321 | A2KTRR700 | 213305 | ||||||
Davita 4004 Tampa West | 4515 George Road, Suite 300 | Tampa | FL | 33634 | G1N442E00 | 230262 | ||||||
Davita 4066 Tampa Central | 4204 North Macdill Avenue South | Tampa | FL | 33607 | Q3L5I6700 | 209332 | ||||||
Davita 4310 Greater Tampa At Home | 4204 N. Macdill Ave Ste B. | Tampa | FL | 33607 | F5LMRFX00 | 1463608 | ||||||
Davita Usf | 10770 N. 46th St. Ste A100 | Tampa | FL | 33617 | CEHENMU00,L9G40HV00 | 213576 | ||||||
Davita - Temple Terrace | 11306 53rd Street | Temple Terrace | FL | 33617 | E8YFJ9R00 | 277641 |
Page 36 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Laurel Manor At the Villages Dialysis Center #2179 | 1950 Laurel Manor Drive, Building 190 | The Villages | FL | 32162 | 8BLE9TK00 | 1216205 | ||||||
Davita - Venice Dialysis Center | 816 Pinebrook Road | Venice | FL | 34285 | 4HPLACH00 | 229133 | ||||||
Davita Indian River Dialysis, LLC | 2150 45th Street, Suite 102 | Vero Beach | FL | 32967 | 33QB3X700 | 1266212 | ||||||
Davita - Jackson South Hospital # 3652-2 - Dialysis-Acute | 9333 Sw 152nd St. Room 244 | Village of Palmetto Bay | FL | 33157 | B57M82J00 | 1463989 | ||||||
Davita Wesley Chapel #2366 | 2255 Green Hedges Way | Wesley Chapel | FL | 33544 | G6QBLBJ00 | 1639441 | ||||||
Davita Wesley Chapel At Home #5934 | 2255 Green Hedges Way | Wesley Chapel | FL | 33544 | 6BTHBEG00 | 1687065 | ||||||
Davita #0670 Dialysis Associates of the Palm Beaches, Inc. | 2611 Poinsettia Ave | West Palm Beach | FL | 33407 | XS2C6Y700 | 210655 | ||||||
Davita Lake Worth At Home | 2459 South Congress Avenue, Suite 100 | West Palm Beach | FL | 33406 | K0L94Q800 | 1232748 | ||||||
Davita Weston Dialysis Center #2035 | 2685 Executive Park Drive, Suite 1 | Weston | FL | 33331 | CKMQH0P00 | 1108946 | ||||||
Davita Winter Garden Dialysis Center #4408 | 1222 Winter Gdn Vineland Rd Ste 100 Bldg, 3 | Winter Garden | FL | 34787 | 5GGR1QJ00 | 1483817 | ||||||
Davita 4030 Winter Haven | 1625 Dr. Martin Luther King Drive | Winter Haven | FL | 33881 | Z41P1LF00 | 210625 | ||||||
Davita -Winter Park Dialysis | 3727 North Goldenrod Road, Suite 101 | Winter Park | FL | 32792 | A7D26JL00 | 1404527 | ||||||
Davita-Winter Park Hemo Dialysis Center # 1994 | 4100 Metric Dr Ste 300 | Winter Park | FL | 32792 | EJNYRGP00 | 1401245 | ||||||
Davita-Winter Park Pd Dialysis Center # 1995 | 4100 Metric Dr Ste 200 | Winter Park | FL | 32792 | CBF7FPD00 | 1473308 | ||||||
Davita East Tampa Dialysis # 2461 | 1701 E. 9th Ave | Ybor City | FL | 33605 | 76DN9RD00 | 1623848 | ||||||
Davita 4068 Zephyrhills | 6610 Stadium Drive | Zephyrhills | FL | 33542 | AHLMXKF00 | 208994 | ||||||
Davita Americus Dialysis Clinic | 227 N. Lee Street | Americus | GA | 31709 | G3RXAL200,MKNZIV500 | 210545 | ||||||
Davita 3130 Athens West | 2047 Prince Ave Ste A | Athens | GA | 30606 | AFD3QPK00 | 210559 | ||||||
Davita #1856 Ralph Mcgill Dialysis | 448 Ralph Mcgill Blvd Ne | Atlanta | GA | 30312 | D1HL0WC00 | 278292 | ||||||
Davita - Southwest Atlanta Nephrology | 3620 Martin Luther King Drive Southwest | Atlanta | GA | 30331 | P8SUZ5N00 | 210549 | ||||||
Davita 3119 Atlanta East | 1308 Moreland Ave | Atlanta | GA | 30316 | J374XNH00 | 230473 | ||||||
Davita 3175 South Fulton | 2685 Metropolitan Pkwy Sw Ste F. | Atlanta | GA | 30315 | JR5E29400 | 208900 | ||||||
Davita 3225 Ford Factory Square Mcgill | 567 North Ave Ste 100 | Atlanta | GA | 30354 | 722AQ0B00 | 209097 | ||||||
Davita 3236 Atlanta West | 2538 Martin Luther King Dr Sw | Atlanta | GA | 30311 | G1R9NDH00 | 235361 | ||||||
Davita 3586 Loring Heights | 1575 Northside Drive Nw, Suite 405 | Atlanta | GA | 30318 | 7ABX4NG00 | 320729 | ||||||
Davita Atlanta Dialysis # 3111 | 567 North Ave Ste 200 | Atlanta | GA | 30354 | 20J01TF00 | 209098 | ||||||
Davita Bakers Ferry Dialysis # 0456 | 3645 Bakers Ferry Rd Sw | Atlanta | GA | 30331 | 78DCRPK00 | 344606 | ||||||
Davita Buckhead Dialysis | 1575 Northside Dr Ne Ste 365 | Atlanta | GA | 30318 | 38501AR00 | 219739 | ||||||
Davita Linden Dialysis # 821 | 121 Linden Avenue | Atlanta | GA | 30308 | T1320FE00 | 208991 | ||||||
Davita Midtown | 489 Peachtree Street, Suite 100 | Atlanta | GA | 30308 | B8QRRF600 | 313026 | ||||||
Davita Midtown Clinic At Home # 6043 | 489 Peachtree Street, Suite 100a | Atlanta | GA | 30308 | DKB6BVK00 | 1199850 | ||||||
Davita Piedmont | 105 Collier Road, Level B. | Atlanta | GA | 30309 | DM8ZXVY00 | 213567 | ||||||
Davita- Lake Hearn Dialysis Center #2071 | 1150 Lake Hearn Dr Ne Ste 100 | Atlanta | GA | 30342 | 84G353300 | 1129529 | ||||||
Davita-South Star Adamsville | 3651 Bakers Ferry Road | Atlanta | GA | 30331 | JFNYRJT00 | 1285480 | ||||||
Davita - Augusta South Wylds Acutes 3094 | 1815 Wylds Rd | Augusta | GA | 30909 | 3DA8VNG00 | 1701074 | ||||||
Davita 3094 Wylds Road | 1815 Wylds Rd | Augusta | GA | 30909 | 7L8YH5K00 | 220761 | ||||||
Nephrology Center of South Augusta | 1631 Gordon Highway, Suite 1b | Augusta | GA | 30906 | 0DX2DJ800 | 280386 | ||||||
Davita Cobb Dialysis #1638 | 3865 Medical Park Dr | Austell | GA | 30106 | JHCTLKA00 | 225300 | ||||||
Davita Colonial Springs Dialysis Center #4472 | 2840 E. West Connector # 350 | Austell | GA | 30106 | E5VB7EA00 | 1648615 | ||||||
Davita 3258 Baxley | 539 Fair Street | Baxley | GA | 31513 | FCLLWWP00 | 235230 | ||||||
Davita - Brunswick Pd | 53 Scranton Connector | Brunswick | GA | 31525 | 88XCBBB00 | 1219349 | ||||||
Davita 3106 Brunswick | 53 Scranton Connector | Brunswick | GA | 31525 | 6D9B08B00 | 210558 | ||||||
Davita 3120 Brunswick South | 4420 Altama Ave Ste 19 | Brunswick | GA | 31520 | JQG34HD00 | 229818 | ||||||
Davita Southeast Georgia Regional Medical Center Acute Dialysis | 2415 Parkwood Dr | Brunswick | GA | 31520 | A2F6FEQ00 | 284931 | ||||||
Davita - Buena Vista | 349 Geneva Rd | Buena Vista | GA | 31803 | 25TBPAA00 | 229034 | ||||||
Buford Dialysis Center #2166 | 1550 Buford Highway, Suite 1e | Buford | GA | 30518 | BKWLCAY00 | 1193346 | ||||||
Davita 3414 Cedartown | 325 West Ave | Cedartown | GA | 30125 | 8BN406G00 | 280928 | ||||||
Davita - West Georgia Dialysis Center #2070 | 1216 Stark Ave | Columbus | GA | 31906 | K98319E00 | 1112550 | ||||||
Davita Columbus At Home | 6228 Bradley Park Drive, Suite B. | Columbus | GA | 31904 | 6974J5E00 | 1279371 | ||||||
Renal Treatment Center - Columbus | 6228 Bradley Park Drive, Suite B. | Columbus | GA | 31904 | 63NAF4P00 | 213323 | ||||||
Davita Conyers Dialysis Center #4421 | 1501 Milstead Rd Ne | Conyers | GA | 30012 | 67EEPPJ00 | 1647734 | ||||||
Davita 2415 Cordele Dialysis Center | 1013 E. 16th Ave | Cordele | GA | 31015 | 34L11GA00 | 1413872 | ||||||
Davita 3441 Cumming | 911 Market Place Blvd Ste 3 | Cumming | GA | 30041 | BJHFERV00 | 281785 | ||||||
Davita Paulding Dialysis | 4019 Johns Rd | Dallas | GA | 30132 | 9197L6H00 | 227414 | ||||||
Davita 3060 South Dekalb | 1757 Candler Rd | Decatur | GA | 30032 | KTXB0TE00 | 209001 | ||||||
Davita Decatur Dialysis | 1987 Candler Road | Decatur | GA | 30032 | 2E3W25M00 | 235089 | ||||||
Davita East Dekalb Dialysis #1951 | 2801 Candler Rd Ste 203 | Decatur | GA | 30034 | JK3T5Y200 | 318638 | ||||||
Davita Lithonia Dialysis Center #2120 | 2485 Park Central Blvd | Decatur | GA | 30035 | 11DHG5H00 | 1138005 | ||||||
Davita Snapfinger Dialysis #1950 | 5255 Snapfinger Park Dr Ste 110 | Decatur | GA | 30035 | J2FQE8C00 | 275164 | ||||||
Davita Southern Lane Dialysis | 1840 Southern Ln | Decatur | GA | 30033 | 08KPJTT00 | 227914 | ||||||
Davita-Lithonia At Home | 2485 Park Central Blvd | Decatur | GA | 30035 | 57YKGNX00 | 1283113 | ||||||
Davita 3040 Douglas | 190 Westside Dr Ste A | Douglas | GA | 31533 | IXDOPNS00 | 210538 | ||||||
Davita Dialysis | 3899 Longview Dr | Douglasville | GA | 30135 | 3L9P3QF00 | 217753 | ||||||
Davita- Arbor Place Dialysis Center # 4400 | 9559 Highway 5 Ste 1 | Douglasville | GA | 30135 | E0PYWEB00 | 1473012 | ||||||
Davita 3224 Laurens County-Dublin | 2400 Bellevue Road, Building 8 | Dublin | GA | 31021 | NCA6QQV00 | 210527 | ||||||
Davita Shamrock Dialysis Center # 4356 | 1016 Claxton Dairy Rd Ste 1a | Dublin | GA | 31021 | 1KEBM0W00 | 1463833 | ||||||
Davita Duluth | 10680 Medlock Bridge Road, Suite 103 | Duluth | GA | 30097 | HAJJ2VQ00 | 1252591 | ||||||
Davita - Athens Dialysis Center | 2026 South Milledge Avenue, Suite A-2 | East Athens | GA | 30605 | 14CKQ5W00 | 1289177 | ||||||
Davita 3445 Atlanta South | 3158 East Main Street, Suite A | East Point | GA | 30344 | AHG2JG800 | 281629 | ||||||
East Point Dialysis | 2669 Church Street | East Point | GA | 30344 | GLTVLFP00 | 276942 | ||||||
Elberton Dialysis Facility, Incorporation | 894 Elbert Street | Elberton | GA | 30635 | EHPHN2Q00 | 210528 | ||||||
Davita #1526 Ellijay Dialysis | 449 Industrial Blvd, Suite 240 | Ellijay | GA | 30540 | 970L3FJ00 | 317860 | ||||||
Davita 3376 Fayetteville | 1279 Highway 54 West, Suite 110 | Fayetteville | GA | 30214 | 7K3768F00 | 276853 | ||||||
Davita Forest Park Dialysis Center | 380 Forest Pkwy | Forest Park | GA | 30297 | BK0980044,H79MGA900 | 287115 | ||||||
Davita Fort Valley Dialysis Center | 557 North Bluebird Boulevard | Fort Valley | GA | 31030 | SL3YE1T00 | 208978 | ||||||
Davita - Gainseville At Home | 2545 Flintridge Road, Suite 130 | Gainesville | GA | 30501 | D6WT40C00 | 1220451 | ||||||
Dialysis of Georgia, LLC - Gainesville | 2545 Flintridge Rd Ste 130 | Gainesville | GA | 30501 | CCAVANQ00 | 286073 | ||||||
Davita # 476 - Iris City Dialysis | 521 North Expressway Village, Suite 1509 | Griffin | GA | 30223 | 2JJX5X300 | 317405 | ||||||
Davita Griffin Dialysis Center | 731 South 8th Street | Griffin | GA | 30224 | NA8OON400 | 210544 | ||||||
Davita 4055 Hinesville Dialysis | 522 Elma G. Miles Pkwy | Hinesville | GA | 31313 | EAA214500 | 209000 | ||||||
Davita Magnolia Oaks Dialysis Center #5035 | 2377 Ga Highway 196 W. | Hinesville | GA | 31313 | FF205MN00 | 1688432 | ||||||
Davita Grovepark #2061 | 794 Mcdonough Road, Suite 103 | Jackson | GA | 30233 | 3GL0JRE00 | 1088724 | ||||||
Davita 3037 Jesup | 301 Peachtree Street | Jesup | GA | 31545 | EDCNFRW00 | 210541 | ||||||
Davita #2302 Spivey Dialysis Center | 1423 Stockbridge Road, Suite B. | Jonesboro | GA | 30236 | 402DKHK00 | 1253328 | ||||||
Davita 6115 Spivey At Home Dialysis | 1423 Stockbridge Rd Suite B. | Jonesboro | GA | 30236 | 26CRDPD00 | 1454423 | ||||||
Davita Jonesboro | 129 King St. | Jonesboro | GA | 30236 | C8CGC3R00 | 210555 | ||||||
Sugarloaf Dialysis Center | 1705 Belle Meade Court, Suite 110 | Lawrenceville | GA | 30043 | 37E53RN00 | 1189220 | ||||||
Davita Sweetwater | 7117 Sweetwater Road | Lithia Springs | GA | 30122 | BE0V4L900 | 317883 | ||||||
Davita Dialysis Center of Middle Georgia | 747 Second Street | Macon | GA | 31201 | GF4CNFD00 | 224349 | ||||||
Davita East Macon Dialysis | 165 Emery Highway, Suite 101 | Macon | GA | 31217 | F4TD6JE00 | 228218 | ||||||
Davita Kennestone At Home Dialysis # 5971 | 200 Cobb Pkwy N. Ste 318 | Marietta | GA | 30062 | DCFF20L00 | 1468102 | ||||||
Davita Kennestone Dialysis Center # 4338 | 200 Cobb Pkwy N. Ste 318 | Marietta | GA | 30062 | F8CV3YV00 | 1463832 | ||||||
Mcdonough Dialysis Center | 114 Dunn Avenue | Mcdonough | GA | 30253 | B6D07GH00 | 276630 | ||||||
Davita 3025 Candler County | 325 Cedar Rd | Metter | GA | 30439 | FD69MLE00 | 232352 | ||||||
Davita Milledgeville | 400 South Wayne Street | Milledgeville | GA | 31061 | G8FHCPL00 | 213339 | ||||||
Davita 3560 Montezuma | 114 Devaughn Ave | Montezuma | GA | 31063 | L3W5C8900 | 319715 | ||||||
Davita Moultrie Dialysis Center | 2419 South Main Street | Moultrie | GA | 31768 | YD5NW9800 | 229662 | ||||||
Dialysis of Georgia, L.L.C. | 1565 East Highway 34, Suite A | Newnan | GA | 30265 | 58EJK7100 | 285270 | ||||||
Davita Peach Tree City Dialysis Center #4420 | 2832 Highway 54 Bldg 100 | Peachtree City | GA | 30269 | 521FYVG00 | 1616716 | ||||||
Kidney Care Perry, LLC | 1027 Keith Drive | Perry | GA | 31069 | 9017L6800 | 281789 | ||||||
Davita - 2452 Pooler Dialysis Center | 54 Traders Way | Pooler | GA | 31322 | A654Y3Q00 | 1463381 | ||||||
Davita Pooler At Home Dialysis | 54 Traders Way | Pooler | GA | 31322 | C4JQHGM00 | 1612264 | ||||||
Davita Southern Crescent Dialysis Center #2186 | 275 Upper Riverdale Road, Suite B. | Riverdale | GA | 30274 | G9YFE9P00 | 1216154 | ||||||
Davita 3002 Rome | 15 John Maddox Dr Nw | Rome | GA | 30165 | AA9HH2T00 | 210566 | ||||||
Davita Rome At Home | 15 John Maddox Drive Nw | Rome | GA | 30165 | 090C1CY00 | 1279408 | ||||||
Davita - North Fulton Dialysis #6306 | 1250 Northmeadow Pkwy Ste 120 | Roswell | GA | 30076 | 03EQ5LX00 | 1413858 | ||||||
Davita 3546 Williams Street Dialysis | 2812 Williams St. | Savannah | GA | 31404 | 0FVCGVX00 | 235136 | ||||||
Davita 3547 Derenne Dialysis | 5303 Montgomery St. | Savannah | GA | 31405 | 06J519400,LFCPB5H00 | 235868 | ||||||
Davita 3548 Abercorn Dialysis | 11706 Mercy Blvd Ste 9 | Savannah | GA | 31419 | 379BB6B00 | 233862 | ||||||
Davita Derenne At Home | 5303 Montgomery Street | Savannah | GA | 31405 | 23HBGKX00 | 1256520 | ||||||
Davita 2167 Snellville Dialysis Center | 2135 Main St. E. Ste 130 | Snellville | GA | 30078 | H3N77QB00 | 1463728 |
Page 37 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita 3544 Effingham North Dialysis Ctr | 301 North Pine Street | Springfield | GA | 31329 | 7K94ABP00 | 233193 | ||||||
Davita 4072 St. Marys Dialysis | 2714 Osborne Rd | St. Marys | GA | 31558 | D3GH0LY00 | 209088 | ||||||
Davita #0642 Nephrology Center of Statesboro | 4b College Plz | Statesboro | GA | 30458 | 1EBSVZC00 | 226418 | ||||||
Davita East Georgia Dialysis Center | 450 Georgia Avenue, Suite A | Statesboro | GA | 30458 | AKJWM5000 | 312187 | ||||||
Davita Dialysis - Spaulding Regional Medical Center # 1055-2-Acute | 1133 Eagel Landing Pkwy | Stockbridge | GA | 30281 | 59A13B300 | 1458002 | ||||||
Davita North Henry Dialysis | 5627 North Henry Blvd, Suite I1 | Stockbridge | GA | 30281 | 8H6J4J100 | 1279755 | ||||||
Davita Mountain Park | 5235 Memorial Drive | Stone Mountain | GA | 30083 | KKKEWB900 | 1249702 | ||||||
Davita 3121 Thomaston | 113a E. County Rd | Thomaston | GA | 30286 | US360TO00 | 209085 | ||||||
Davita - Tifton Dialysis Center | 624 Love Avenue | Tifton | GA | 31794 | 5GFKTLY00 | 1405148 | ||||||
Davita Norhlake Dialysis Center #1639 | 1350 Montreal Road, Suite 200 | Tucker | GA | 30084 | 9ACEMVQ00 | 288302 | ||||||
Davita Tucker Dialysis Center #4410 | 4434 Hugh Howell Rd | Tucker | GA | 30084 | KBC7T4B00 | 1612825 | ||||||
Davita - Union City Dialysis | 6851 Shannon Parkway, Suite 200 | Union City | GA | 30291 | AD2PMXX00 | 1288651 | ||||||
Davita Union City At Home #5965 Dialysis | 6851 Shannon Pkwy 200 | Union City | GA | 30291 | E2KR15X00 | 1473177 | ||||||
Davita Oak Street Dialysis # 3005 | 2704 N. Oak St. Bldg H | Valdosta | GA | 31602 | 4Y9P4NR00 | 210557 | ||||||
Davita - Vadalia First Street Dialysis #1960 | 906 E. 1st St. Ste B. | Vidalia | GA | 30474 | DK7KJ8F00 | 317790 | ||||||
Davita of Vidalia | 1806 Edwina Drive | Vidalia | GA | 30474 | 0AI6NI300 | 210530 | ||||||
Dialysis Center of Middle Georgia | 509 North Houston Road | Warner Robins | GA | 31093 | DH6H19R00 | 233195 | ||||||
Davita Washington Dialysis Center | 154 Washington Plaza | Washington | GA | 30673 | 01OF0JN00,BL28M4W00 | 210546 | ||||||
Davita Waycross Dialysis Center # 2352 | 308 Carswell Ave | Waycross | GA | 31501 | 83J8WGE00 | 1608964 | ||||||
Davita of Woodstock | 2001 Professional Parkway, Suite 100 | Woodstock | GA | 30188 | 1.54E+04 | 312200 | ||||||
Davita 3564 Wrightsville | 2240 W. Elm St. | Wrightsville | GA | 31096 | HFT9RNC00 | 319713 | ||||||
Davita, Dba; Atlantic Dialysis Center #1597 | 1500 East 10th Street Suite B. | Atlantic | IA | 50022 | 1JXAG9G00 | 281513 | ||||||
Davita 3527 Council Bluffs | 300 West Broadway, Suite 150 | Council Bluffs | IA | 51503 | 53X8H9300 | 236133 | ||||||
Davtia #1596, dba ; Creston Dialysis | 1700 West Townline | Creston | IA | 50801 | B7H2RXP00 | 255717 | ||||||
Davita Dialysis Central Des Moines #1594 | 1215 Pleasant Street, Suite 106 | Des Moines | IA | 50309 | WQVNX2300 | 210402 | ||||||
Davita East Des Moines At Home | 1301 Pennsylvania Avenue, Suite 208 | Des Moines | IA | 50316 | 3DFOEDM00 | 1269560 | ||||||
Davita East Des Moines Dialysis Center #2132 | 1301 Pennsylvania Ave Ste 208 | Des Moines | IA | 50316 | 67XRJJ300 | 1137994 | ||||||
Davita Riverpoint Dialysis | 501 Southwest 7th Street, Suite B. | Des Moines | IA | 50309 | F323H0400 | 1080217 | ||||||
Davita Grundy Dialysis Center #5023 | 101 E. J. Ave Suite 110 | Grundy Center | IA | 50638 | 16RB4LY00 | 1692350 | ||||||
Davita # 1573 Harlan Dialysis | 1213 Garfield Avenue | Harlan | IA | 51537 | 620670LF2 | 278553 | ||||||
Davita Buchanan County Dialysis #1925 | 1600 1st St. E. | Independence | IA | 50644 | 3D5QLD900 | 1662129 | ||||||
Davita #1598, Dba; Newton Dialysis | 204 North 4th Avenue East, Suite 134 | Newton | IA | 50208 | K1C7G1L00 | 312448 | ||||||
Davita Perry Dialysis Center #2134 | 610 Tenth Street, Suite L100 | Perry | IA | 50220 | 86EKFA100 | 1189550 | ||||||
Davita Shenandoah Dialysis #1574 | 300 Pershing | Shenandoah | IA | 51601 | LATL40D00 | 278554 | ||||||
Davita - Cedar Valley Dialysis Center #1980 | 1661 W. Ridgeway Ave | Waterloo | IA | 50701 | BA2LJ7Y00 | 276083 | ||||||
Davita Black Hawk Dialysis # 1927 | 3421 W. 9th St. | Waterloo | IA | 50702 | 72VPY5W00 | 1545084 | ||||||
Davita #1926 Waverly Dialysis | 220 10th St. Sw | Waverly | IA | 50677 | G22R5AQ00 | 1545092 | ||||||
Davita #1595, dba ; West Des Moines Dialysis | 6800 Lake Drive, Suite 185 | West Des Moines | IA | 50266 | 54NVXWK00 | 231992 | ||||||
Davita - West Union Dialysis Center #1981 | 405 Highway 150 North, PO Box 516 | West Union | IA | 52175 | C650C1000 | 1062521 | ||||||
Davita Southwest Idaho Advanced Care Hospital-Acute | 6651 W. Franklin Rd | Boise | ID | 83709 | FFPPVKN00 | 1474594 | ||||||
Davita Table Roack At Home | 5610 West Gage Street, Suite B. | Boise | ID | 83706 | FBNV4BN00 | 1270147 | ||||||
Davita Table Rock Dialysis Center # 1814 | 5610 Gage St. Ste B. | Boise | ID | 83706 | 3LBF72N00 | 231097 | ||||||
Davita Table Rock Dialysis Pd | 5610 West Gage Street, Suite B. | Boise | ID | 83706 | LB45QC700 | 1212212 | ||||||
Davita Burley Dialysis | 741 N. Overland Ave | Burley | ID | 83318 | 8A3794500 | 236145 | ||||||
Davita Burley Dialysis Pd | 741 N. Overland Ave | Burley | ID | 83318 | 0L9428800 | 1432813 | ||||||
Davita Caldwell Dialysis Center #2364 | 821 Smeed Pkwy | Caldwell | ID | 83605 | HDTPTMR00 | 1474595 | ||||||
Davita Caldwell Dialysis Center Pd-Id #5028 | 821 Smeed Pkwy | Caldwell | ID | 83605 | 1GBHH5V00 | 1483852 | ||||||
Davita Treasure Valley Dialysis #1812 | 3525 East Louise Drive, Suite 155 | Meridian | ID | 83642 | A7Y8CA900 | 1219152 | ||||||
Davita Treasure Valley Dialysis #1836 Pd Unit | 3525 East Louise Drive Suite 155 | Meridian | ID | 83642 | A7Y8CA9F1 | 1270106 | ||||||
Davita Moscow Dialysis # 4325 | 212 Rodeo Dr Suite 101 | Moscow | ID | 83843 | E3397JJ00 | 1612804 | ||||||
Davita Nampa Dialysis Ctr | 846 Park Centre Way | Nampa | ID | 83651 | CBLYPC700 | 231098 | ||||||
Nampa Dialysis Pd | 846 Parkcentre Way | Nampa | ID | 83651 | 66FCVXV00 | 1212219 | ||||||
Gate City Dialysis Center | 2001 Bench Rd | Pocatello | ID | 83201 | BBKJALK00 | 280898 | ||||||
Gate City Dialysis Pd | 2001 Bench Road | Pocatello | ID | 83201 | 76BYKJP00 | 1212210 | ||||||
Davita Twin Falls At Home | 1840 Canyon Crest Drive | Twin Falls | ID | 83301 | ECBKFYY00 | 1270149 | ||||||
Davita Twin Falls Dialysis Center | 1840 Canyon Crest Dr | Twin Falls | ID | 83301 | 9E59P6W00 | 281039 | ||||||
Davita Twin Falls Dialysis Pd | 1840 Canyon Crest | Twin Falls | ID | 83301 | KL4TH1K00 | 1212215 | ||||||
Davita 3449 Alton | 3511 College Ave | Alton | IL | 62002 | 460Y16F00 | 313039 | ||||||
Davita Metro East Dialysis Center #1720 | 5105 West Main Street | Belleville | IL | 62226 | V3VY8SR00 | 210463 | ||||||
Davita- Metro East At Home | 5105 West Main Street | Belleville | IL | 62226 | 4BARH4100 | 1282864 | ||||||
Davita #1694 Benton Dialysis | 1151 Route 14 West | Benton | IL | 62812 | B0LNKMP00 | 285947 | ||||||
Davita - Bourbonnais Dialysis | 581 William Latham Drive, Suite 104 | Bourbannais | IL | 60914 | LE6YMXM00 | 1252616 | ||||||
Davita - Kankakee County Pd | 581 William Lathan Drive, Suite 104 | Bourbonnais | IL | 60914 | KDNXDNH00 | 1398220 | ||||||
Nephroplex Dialysis of Centralia | 1231 State Road 161 | Centralia | IL | 62801 | EGM8Q6K00,HGW84BG00 | 285948 | ||||||
Davita - Illini Renal At Home Dialysis 6086 | 507 East University Avenue | Champaign | IL | 61820 | 66G8H5M00 | 1088751 | ||||||
Davita - Llini Renal Dialysis 3580 Champaign | 507 East University | Champaign | IL | 61820 | 4G15L0B00 | 320723 | ||||||
Davita #6244 - Kennedy Home Dialysis At Home | 5509 N. Cumberland Ave Ste 515 | Chicago | IL | 60656 | 6B0DBCH00 | 1289100 | ||||||
Davita - Montclare | 7009 West Belmond Avenue | Chicago | IL | 60634 | 018AM3800 | 347183 | ||||||
Davita - Woodlawn Home Program # 5581 | 5841 S. Maryland Ave Room L026 | Chicago | IL | 60637 | GFY47DH00 | 1701070 | ||||||
Davita - Woodlawn Home Program At Home # 5933 | 5841 S. Maryland Ave Room L026 | Chicago | IL | 60637 | AF1FLTJ00 | 1701071 | ||||||
Davita Beverly At Home #5949 | 8109 S. Western Ave | Chicago | IL | 60620 | AC0TMEF00,D1FCQ3Y00 | 1621350 | ||||||
Davita Beverly Dialysis Center #1785 | 8109 S. Western Ave | Chicago | IL | 60620 | 9KR6CFH00 | 342110 | ||||||
Davita Children’s Dialysis Center | 2611 North Halsted Street | Chicago | IL | 60614 | 27QXLJ000 | 235955 | ||||||
Davita Emerald Dialysis | 710 West 43rd Street | Chicago | IL | 60609 | 81QX0LH00 | 210461 | ||||||
Davita Emerald Pd | 710 East 43rd Street | Chicago | IL | 60609 | 96N99H100 | 1233089 | ||||||
Davita Lake Park Dialysis #5578 | 1531 E. Hyde Park Blvd | Chicago | IL | 60615 | 1CH6WJF00 | 1700878 | ||||||
Davita Little Village Dialysis Center | 2335 West Cermak Road | Chicago | IL | 60608 | JFMNLA200 | 1139399 | ||||||
Davita Logan Square Dialysis Services, Inc. | 2659 North Milwaukee Avenue | Chicago | IL | 60647 | OLUX4JN00 | 210456 | ||||||
Davita Mount Greenwood Dialysis Center #2118 | 3401 111th Street | Chicago | IL | 60655 | HD81Y4500 | 1125974 | ||||||
Davita Mount Greenwood Pd #1830 | 3401 111th Street | Chicago | IL | 60655 | C4KADXK00 | 1212501 | ||||||
Davita Skyline Home Dialysis | 7009 West Belmont Avenue | Chicago | IL | 60634 | 5GP892T00 | 225103 | ||||||
Davita Stony Island Dialysis # 5579 | 8725 South Stony Island Avenue | Chicago | IL | 60617 | KKKARYN00 | 318861 | ||||||
Davita West Lawn Dialysis Center #4363 | 7000c S. Pulaski Rd | Chicago | IL | 60629 | 1K1LHTH00 | 1653409 | ||||||
Davita Woodlawn Dialysis # 5580 | 1164 East 55th Street | Chicago | IL | 60615 | 64PN9QL00 | 210502 | ||||||
Davita-Mt. Greenwood At Home | 3401 West 111th Street | Chicago | IL | 60655 | JHJY6AX00 | 1282840 | ||||||
Lincoln Park Dialysis Services - Total Renal Care | 3157 North Lincoln Avenue | Chicago | IL | 60657 | PQK8MMF00 | 210462 | ||||||
Chicago Heights Dialysis Center | 177 W. Joe Orr Rd Suite B. | Chicago Heights | IL | 60411 | 3050DCX00 | 345029 | ||||||
Davita 1824 Chicago Heights Pd/Home Hemo Dialysis | 177 W. Joe Orr Rd Ste B. | Chicago Heights | IL | 60411 | J7719GN00 | 1454262 | ||||||
Davita Crystal Springs Dialysis #5550 | 4900 S. Il Route 31 | Crystal Lake | IL | 60012 | A62QBCV00 | 1695247 | ||||||
Davita 3315 Macon County | 1090 West McKinley Avenue | Decatur | IL | 62526 | 7NGKWTJ00 | 232489 | ||||||
Davita 6085 Decatur East Wood At Home | 794 E. Wood St. | Decatur | IL | 62523 | J8TYK6800 | 1413857 | ||||||
Davita Decature East Wood | 794 East Wood Street, Suite # 425 | Decatur | IL | 62523 | 5546B1W00,5546B1WF1 | 281741 | ||||||
Dixon Kidney Center #2099 | 1131 North Galena Avenue | Dixon | IL | 61021 | 5458MBJ00 | 1108400 | ||||||
Davita Sauget Dialysis | 2061 Goose Lake Rd | East St. Louis | IL | 62206 | FCCE5TF00 | 224554 | ||||||
Daivta Edwardsville Dialysis Center # 2414 | 235 S. Buchanan St. | Edwardsville | IL | 62025 | DCK4XDN00 | 1465965 | ||||||
Davita - Effingham At Home | 904 Medical Park Drive, Suite 4 | Effingham | IL | 62401 | H4GDMGG00 | 1288713 | ||||||
Davita Effingham | 904 Medical Park Drive, Suite 1 | Effingham | IL | 62401 | 33HG7NX00 | 232487 | ||||||
Davita Cobblestone Dialysis #5551 | 934 Center St. | Elgin | IL | 60120 | 53KD4MV00 | 1695246 | ||||||
Davita - Wayne County Dialysis Center | 303 North West 11th Street | Fairfield | IL | 62837 | KDCMWJA00 | 1289054 | ||||||
Davita Freeport Dialysis Unit | 1028 S. Kunkle Blvd | Freeport | IL | 61032 | DLYL9ND00 | 314898 | ||||||
Granite City Dialysis | #9 American Village Shopping Center | Granite City | IL | 62040 | 0E0LGGV00 | 210453 | ||||||
Davita 3317 Jacksonville | 1515 W. Walnut St. Ste 11 | Jacksonville | IL | 62650 | 6B6451X00 | 232488 | ||||||
Davita 2223 Lake Villa Home Dialysis Pd | 37809 N. Illinois Route 59 | Lake Villa | IL | 60046 | D114VWA00 | 1454257 | ||||||
Lake Villa Dialysis Center #2119 | 37809 North Illinois Route 59 | Lake Villa | IL | 60046 | 51GHLG400 | 1139381 | ||||||
Lake County Dialysis | 918 South Milwaukee | Libertyville | IL | 60048 | A714B8500 | 213362 | ||||||
Davita 3322 Lincoln | 2100 5th St. | Lincoln | IL | 62656 | 7JQ1MGJ00 | 232491 | ||||||
Davita 3318 Litchfield | 915 St. Francis Way | Litchfield | IL | 62056 | 52YEAWP00 | 232490 | ||||||
Davita Lockport At Home Dialysis #5999 | 16626 W. 159th St. Ste 703 | Lockport | IL | 60441 | HF1670A00 | 1454042 | ||||||
Davita #6099 Marion | 324 S. 4th St. | Marion | IL | 62959 | HH1P9PM00 | 229788 | ||||||
Davita Marion At Home | 324 S. 4th Street | Marion | IL | 62959 | 4GX51H400 | 1279373 | ||||||
Davita #1910 Maryville Dialysis Pd | 2136 Vadalabene Dr Ste B. | Maryville | IL | 62062 | KJMHKLB00 | 1285289 |
Page 38 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita #6125 Maryville At Home | 2136 Vadalabene Dr, Ste B. | Maryville | IL | 62062 | LB22VA500 | 1282824 | ||||||
Davita- Maryville Dialysis Center | 2130 Vadalabene Dr | Maryville | IL | 62062 | C10JD0900 | 344957 | ||||||
Davita Olympia Fields | 4557b West Lincoln Highway | Matteson | IL | 60443 | 2LHWQ1R00 | 213366 | ||||||
Davita Olympia Fields Dialysis Pd | 4557b Lincoln Hwy | Matteson | IL | 60443 | 950HBBH00 | 1436108 | ||||||
Davita 3319 Mattoon | 200 Richmond Avenue East | Mattoon | IL | 61938 | FKB0D0N00 | 232492 | ||||||
Davita - Mount Vernon At Home | 1800 Jefferson Avenue | Mount Vernon | IL | 62864 | EJLR3Q200 | 1220452 | ||||||
Nephroplex Dialysis of Mount Vernon | 1800 Jefferson Ave | Mount Vernon | IL | 62864 | H1QAZAR00 | 210458 | ||||||
Davita Big Oaks Dialysis Center # 4362 | 5623 W. Touhy Ave | Niles | IL | 60714 | JGNEQKA00 | 1624063 | ||||||
Davita #1784 Stony Creek Dialysis | 9115 S. Cicero Ave Ste B. | Oak Lawn | IL | 60453 | 26R71EL00 | 1142179 | ||||||
Davita Dialysis Olney #1731 | 117 North Boone Street | Olney | IL | 62450 | E3X54QD00 | 318484 | ||||||
Davita #5520 Pittsfield Dialysis | 640 W. Washington St. | Pittsfield | IL | 62363 | 235X0AH00 | 1623919 | ||||||
Davita Adams County At Home #5948 | 436 N. 10th St. | Quincy | IL | 62301 | FD53L1M00 | 1623921 | ||||||
Davita Adams County Dialysis #5519 | 436 N. 10th St. | Quincy | IL | 62301 | F9QDXRD00,F9QDXRF00 | 1623920 | ||||||
Davita Robinson Dialysis Center #4381 | 1215 N. Allen St. | Robinson | IL | 62454 | E324JDJ00 | 1640110 | ||||||
Davita 1563 Rockford Dialysis | 3339 N. Rockton Ave | Rockford | IL | 61103 | 2FF89LY00 | 314895 | ||||||
Davita Churchview Dialysis Unit | 5970 Churchview Drive | Rockford | IL | 61107 | 4EN8H1V00,RQ9FJRFF1 | 314899 | ||||||
Davita Roxbury Dialysis Center #2097 | 622 Roxbury Rd | Rockford | IL | 61107 | CAW45PG00 | 1129469 | ||||||
Davita Stonecrest Dialysis #5539 | 1302 E. State St. | Rockford | IL | 61104 | B0F0RCT00 | 285476 | ||||||
Davita-Roxbury At Home | 622 Roxbury Rd | Rockford | IL | 61107 | 0LHFBC400 | 1282494 | ||||||
Davita 3491 Rushville | 112 Sullivan Dr | Rushville | IL | 62681 | 56ELPHG00 | 316225 | ||||||
Davita 3320 Springfield Central | 932 N. Rutledge St. Floor 1 | Springfield | IL | 62702 | 64R3K3R00 | 232486 | ||||||
Davita 3420 Springfield Montvale | 2930 South Montvale Drive, Suite A | Springfield | IL | 62704 | DEHBRNX00 | 280555 | ||||||
Davita Springfield Central At Home | 932 N. Rutledge St. Fl 2 | Springfield | IL | 62702 | EB49VHEF1 | 1088713 | ||||||
Davita Whiteside Dialysis | 2600 North Locust Avenue, Suite D | Sterling | IL | 61081 | 90YX2PV00 | 314900 | ||||||
Davita Sycamore Dialysis Center | 2200 Gateway Dr | Sycamore | IL | 60178 | FK9BMCH00 | 1129565 | ||||||
Davita 3321 Taylorville | 901 W. Spresser St. | Taylorville | IL | 62568 | ADE2JPB00 | 233715 | ||||||
Davita Vandalia Dialysis Center | 301 Mattes Ave | Vandalia | IL | 62471 | C25TRTW00 | 1448651 | ||||||
Davita Batesville Dialysis Center | 232 State Road 129 North | Batesville | IN | 47006 | NKICRTL00 | 210423 | ||||||
Davita Hoosier Dialysis Center #2450 | 143 S. Kingston Dr | Bloomington | IN | 47408 | 05AM7PX00 | 1621209 | ||||||
Davita Hoosier Hills At Home #5946 | 143 S. Kingston Dr | Bloomington | IN | 47408 | 1JT7BKF00 | 1624060 | ||||||
Davita 2449 Carmel Dialysis | 180 E. Carmel Dr | Carmel | IN | 46032 | 12P9VFB00 | 1414340 | ||||||
Davita Chesterton Dialysis Center | 711 Plaza Dr Ste 6 | Chesterton | IN | 46304 | E334YPB00 | 1448652 | ||||||
Davita - Corydon Dialysis | 1937 Old State Road 135 N. W. | Corydon | IN | 47112 | ACBW6HG00 | 1285339 | ||||||
Davita Dialysis- East Chicago | 4320 Fir St. Unit 404 | East Chicago | IN | 46312 | GEGHJDN00 | 278238 | ||||||
Davita East Evansville At Home #6090 | 1312 Professional Boulevard, Suite 100 | Evansville | IN | 47714 | HFWJ80J00 | 1269829 | ||||||
Davita East Evansville Dialysis #1725 | 1312 Professional Boulevard, Suite 100 | Evansville | IN | 47714 | 15XDM0200 | 231503 | ||||||
Davita East Evansville Dialysis Pd #1732 | 1312 Professional Boulevard, Suite 100 | Evansville | IN | 47714 | H3T763T00 | 1162651 | ||||||
Davita North Evansville Dialysis Center #1726 | 1151 West Buena Vista Road | Evansville | IN | 47710 | 2GC3NWG00 | 307714 | ||||||
Davita Franklin At Home | 1140 West Jefferson Street, Suite A | Franklin | IN | 46131 | J105PFT00 | 1275991 | ||||||
Davita Franklin Dialysis | 1140 West Jefferson Street, Suite A | Franklin | IN | 46131 | 75PK9TN00 | 1250000 | ||||||
Davita - Gary | 4802 Broadway | Gary | IN | 46408 | SQQFZDZ00 | 218763 | ||||||
Davita Greensburg At Home Dialysis #6234 | 1531 N. Commerce East Dr Suite 6 | Greensburg | IN | 47240 | B6WEXWK00 | 1453973 | ||||||
Davita-Greensburg Dialysis Center | 1531 N. Commerce East Dr Suite 6 | Greensburg | IN | 47240 | AKPVHC700 | 1288823 | ||||||
Davita - Indy South Dialysis Center | 972 Emerson Parkway, Suite E. | Greenwood | IN | 46143 | 50EYE1W00 | 1398184 | ||||||
Davita - Hammond | 222 Douglas Street | Hammond | IN | 46320 | UL25RR400 | 218764 | ||||||
Davita Hammond Pd #1826 | 222 Douglas Street | Hammond | IN | 46320 | 2KW93VP00 | 1212498 | ||||||
Davita-Hammond At Home | 222 Douglas St. | Hammond | IN | 46320 | JJ0R96800 | 1283050 | ||||||
Davita Westview At Home Dialysis | 3749 Commercial Dr Suite B. | Indianapolis | IN | 46222 | 1DKGAG400 | 1273097 | ||||||
Davita Westview Dialysis | 3749 Commercial Dr | Indianapolis | IN | 46222 | BEW4AQP00 | 1233079 | ||||||
Davita Jasper Dialysis Center #1728 | 721 West 13th Street, Suite 105 | Jasper | IN | 47546 | JJMQQ2600 | 276278 | ||||||
Davita - Lawrenceburg Dialysis | 555 Eads Parkway, Suite 200 | Lawrenceburg | IN | 47025 | X7NQE9400 | 208891 | ||||||
Davita Madison | 220 Clifty Drive Unit K | Madison | IN | 47250 | 87VN2NM00 | 208894 | ||||||
Davita Merrillville Dialysis | 9223 Taft St. | Merrillville | IN | 46410 | 03H9VK800 | 319884 | ||||||
Davita Merrillville Dialysis Pd | 9223 Taft Street | Merrillville | IN | 46410 | FKPALVE00 | 1212495 | ||||||
Davita - Michigan City | 9836 W. 400 N. Suite A | Michigan City | IN | 46360 | 98KD71M00,J4EQ55100 | 235399 | ||||||
Davita - Michigan City Pd | 9836 W. 400 N. Suite A | Michigan City | IN | 46360 | 5J9R35W00 | 1212497 | ||||||
Davita - Munster | 8317 Calumet Avenue, Suite A | Munster | IN | 46321 | KGC5LNP00 | 235772 | ||||||
Davita New Albany Dialysis Center | 2669 Charlestown Road, Suite E. and F. | New Albany | IN | 47150 | 95XF9YX00 | 1116182 | ||||||
Davita North Vernon Dialysis Center #4358 | 2340 N. State Highway 7 Ste A | North Vernon | IN | 47265 | CJG1ARD00 | 1468234 | ||||||
Davita Dialysis of Portage | 5823 Us Highway 6 | Portage | IN | 46368 | BK84EPA00 | 1449295 | ||||||
Davita #2256 Princeton | 2227 Sherman Dr | Princeton | IN | 47670 | 9DTQRRN00 | 1449382 | ||||||
Davita Rush County Dialysis Center #4359 | 1400 N. Cherry St. | Rushville | IN | 46173 | KG8VYAB00 | 1473075 | ||||||
Davita Salem Dialysis | 1201 N. Jim Day Road, Suite 103 | Salem | IN | 47167 | D2HWP4L00 | 1279759 | ||||||
Davita Dialysis of St. John | 10033 Wicker Ave Ste 6 | St. John | IN | 46373 | 739QNQM00 | 1449297 | ||||||
Tell City Dialysis Center #1531 | 1602 Main Street | Tell City | IN | 47586 | 51C9P7N00 | 314917 | ||||||
Davita - Valparaiso | 606 Lincolnway | Valparaiso | IN | 46383 | F8Q0MA900 | 227605 | ||||||
Davita - Valparaiso Pd #1827 | 606 Lincolnway | Valparaiso | IN | 46383 | LJLPQ7B00 | 1212499 | ||||||
Davita Dialysis Vincennes #1727 | 700 Willow Street, Suite 101 | Vincennes | IN | 47591 | BJKJBY600 | 318483 | ||||||
Davita Vincennes At Home | 700 Willow Street | Vincennes | IN | 47591 | 9BHRV8V00 | 1279808 | ||||||
Davita Davies County Dialysis Center #1729 | 310 Northeast 14th Street | Washington | IN | 47501 | C125X4L00 | 281794 | ||||||
Davita - Derby | 250 West Red Powell Road | Derby | KS | 67037 | 54K21PL00 | 235687 | ||||||
Davita -Renal Treatment Centers - Garden City | 401 N. Main St. | Garden City | KS | 67846 | 1J9AVGE00 | 213391 | ||||||
Davita - Horton Dialysis Center #2460 | 1901 Euclid Avenue | Horton | KS | 66439 | G8WJTFB00 | 1283196 | ||||||
Total Renal Care - Independence Dialysis | 801 West Myrtle | Independence | KS | 67301 | 9DT2K2300 | 213393 | ||||||
Davita - Wyandotte Dialysis Center #1956 | 4837 State Ave | Kansas City | KS | 66102 | KYKYDCP00 | 230621 | ||||||
Davita 3517 Wyandotte West | 8919 Parallel Parkway, Suite 121 | Kansas City | KS | 66112 | 995Q9G200 | 278178 | ||||||
Davita Wyandotte Dialysis | 3737 State Avenue, Suite 100 | Kansas City | KS | 66102 | F7GAEA000 | 1246359 | ||||||
Davita Leavenworth | 501 Oak Street | Leavenworth | KS | 66048 | 5JQX1P100 | 1249964 | ||||||
Davita - Johnson County Dialysis #1954 | 10453 W. 84th Ter | Lenexa | KS | 66214 | BA68Z4200 | 210399 | ||||||
Davita Lenexa At Home Dialysis | 8630 Halsey St. | Lenexa | KS | 66215 | 241C85W00 | 1496574 | ||||||
Grambro Healthcare Lenexa | 8630 Halsey Street | Lenexa | KS | 66215 | 42VEANC00 | 209005 | ||||||
Davita - Newton | 1223 Washington Road | Newton | KS | 67114 | 354TB0G00 | 235090 | ||||||
Davita 3457 Olathe | 732 West Frontier | Olathe | KS | 66061 | 73EDA3E00 | 342099 | ||||||
Davita Parsons | 1902 South Highway 59, Building B. Labette County Medical Center | Parsons | KS | 67357 | 39PPN2F00 | 235086 | ||||||
Davita Pratt Dialysis Center | 203 South Watson Suite 110 | Pratt | KS | 67124 | 2E4166X00 | 277689 | ||||||
Da Vita - East Wichita Dialysis | 320 North Hillside | Wichita | KS | 67214 | AYT5A7N00 | 224565 | ||||||
Davita #6133 At Home | 909 North Topeka Street | Wichita | KS | 67214 | A9XGG7J00 | 1275998 | ||||||
Davita - Wichita Pd | 909 North Topeka Street | Wichita | KS | 67214 | CA86XPM00 | 1218564 | ||||||
Davita -Wichita Dialysis | 909 North Topeka | Wichita | KS | 67214 | F6KCM7A00 | 210397 | ||||||
Northeast Wichita Dialysis Center | 2630 North Webb Road, Building 100, Suite 100 | Wichita | KS | 67226 | 22XXV0T00 | 345193 | ||||||
Total Renal Care - Winfield Dialysis | 1315 East 4th Avenue | Winfield | KS | 67156 | FFE9JLL00 | 232987 | ||||||
Davita - Bardstown Dialysis Center #2055 | 210 West John Fitch Avenue | Bardstown | KY | 40004 | FJE22GW00 | 1080127 | ||||||
Davita Sheperdsville Dialysis Center #4386 | 150 Brooks Way Ste 15 | Brooks | KY | 40109 | B9TJHYB00 | 1497148 | ||||||
Davita #0556 Taylor County Dialysis Ctr | 101 Kingswood Drive | Campbellsville | KY | 42718 | YHAS2EX00 | 213398 | ||||||
Davita - Cold Springs Dailysis | 430 Crossroads Boulevard | Cold Springs | KY | 41076 | 1HLXLVG00 | 1262880 | ||||||
12th Street Covington Davita Dialysis Center 4488 | 1500 James Simpson Jr Way Ste 1100 | Covington | KY | 41011 | C90A0QL00 | 1640009 | ||||||
Woodland Dialysis Center | 912 Woodland Drive | Elizabethtown | KY | 42701 | 540VF4N00,A2WXLB100 | 210381 | ||||||
Davita Turfway | 11 Spiral Dr Ste 15 | Florence | KY | 41042 | 4BXPPD300 | 1249660 | ||||||
Davita Turfway Dialysis Pd Clinic | 11 Spiral Drive, Suite 15a | Florence | KY | 41042 | LHNXJ9E00 | 1275452 | ||||||
Davita 3276 Crestview Hills | 400 Centre View Boulevard | Fort Mitchell | KY | 41017 | 0GV23P500 | 227683 | ||||||
Paintsville Dialysis Center | 4750 Kentucky Route 321 South | Hagerhill | KY | 41222 | G4L7C7V00 | 314982 | ||||||
Davita Gardenside Dialysis Center #1730 | 70 North Gardenmile Road | Henderson | KY | 42420 | 6A229QJ00 | 276271 | ||||||
Davita 3041 Hopkinsville | 1914 S. Virginia St. | Hopkinsville | KY | 42240 | J9DH56X00 | 213402 | ||||||
Davita 3464 Christian County | 200 Burley Ave | Hopkinsville | KY | 42240 | KCRGTFB00 | 315123 | ||||||
Davita - Lagrange Dialysis Center | 240 Parker Dr | Lagrange | KY | 40031 | BKJTFL700 | 1157877 | ||||||
Davita #2139 Leitchfield Dialysis Center | 912 Wallace Avenue, Suite 106 | Leitchfield | KY | 42754 | C15KDL000 | 1161355 | ||||||
Davita Hamburg Dialysis Center # 4377 | 1745 Alysheba Way | Lexington | KY | 40509 | GBDLP0E00 | 1483816 | ||||||
Davita - Louisville Dialysis Center #2107 | 8037 Dixie Hwy | Louisville | KY | 40258 | 32FC5KL00 | 1112555 | ||||||
Davita - Springhurst Dialysis Center #2195 | 10201 Champion Farms Drive | Louisville | KY | 40241 | C83JEWG00 | 1189547 | ||||||
Davita Louisville | 720 West Broadway | Louisville | KY | 40202 | 7CJ9FC200 | 1221002 | ||||||
Davita- Meadows East Dialysis | 2529 Six Mile Lane | Louisville | KY | 40220 | L4YAD4E00 | 1279769 |
Page 39 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita-West Broadway At Home | 720 West Broadway | Louisville | KY | 40202 | CK30LM600 | 1282886 | ||||||
Davita - Madisonville Acute Dialysis # 1105 | 900 Hospital Dr | Madisonville | KY | 42431 | 86B0TGY00 | 1464200 | ||||||
Davita - Madisonville Dialysis | 435 N. Kentucky Ave | Madisonville | KY | 42431 | C26R73L00 | 210379 | ||||||
Davita - Maysville #2322 | 489 Tucker Drive | Maysville | KY | 41056 | GB0FC5N00 | 1283243 | ||||||
Owensboro Dialysis Center #1530 | 1930 E. Parrish Ave | Owensboro | KY | 42303 | 9CX27PG00 | 282173 | ||||||
Davita Bourbon County Dialysis Center #4384 | 213 Letton Dr | Paris | KY | 40361 | G92PEKE00 | 1639470 | ||||||
Eastern Kentucky Dialysis Center #1583 | 167 Weddington Branch Road | Pikeville | KY | 41501 | 27GXTN200 | 235279 | ||||||
Davita - South Williamson Dialysis Center # 4306 | 204 Appalachian Plz | South Williamson | KY | 41503 | 776R09K00 | 1473249 | ||||||
Davita 3291 South Hill | 525 Alexandria Pike, Suite 120 | Southgate | KY | 41071 | FC8CEPE00 | 275301 | ||||||
Davita Versailles Dialysis Center #4385 | 480 Lexington Rd | Versailles | KY | 40383 | 51EC1NK00 | 1647709 | ||||||
Davita Whitesburg Dialysis Center #1585 | 222 Hospital Road, Suite D | Whitesburg | KY | 41858 | 22P1T2P00 | 346415 | ||||||
Davita Williamstown Dialysis Center | 103 Barnes Rd Suite A | Williamstown | KY | 41097 | A9ETQ9P00 | 1428611 | ||||||
Davita | 3888 North Blvd | Baton Rouge | LA | 70806 | 13AF1LF00 | 1196771 | ||||||
Bogalusa Kidney Care - Davita | 2108 South Avenue F. | Bogalusa | LA | 70427 | WD4068R00 | 210318 | ||||||
Dialysis Systems of Covington - Davita #1535 | 210 Greenbriar Blvd | Covington | LA | 70433 | 93V19R800 | 277498 | ||||||
Davita Denham Springs Dialisys | 26737 Highway 1032 | Denham Springs | LA | 70726 | 26GB7GM00 | 1232782 | ||||||
Davita 3528 Deridder | 239 E. 1st St. | Deridder | LA | 70634 | J3E3JN900 | 232033 | ||||||
Davita 2606 Donaldsonville | 101 Plimsol Dr | Donaldsonville | LA | 70346 | DK4QGAH00 | 226881 | ||||||
Washington Parish Kidney Care | 724 Washington Street | Franklinton | LA | 70438 | E7LDHLL00 | 278501 | ||||||
Davita 3603 Magnolia Dialysis | 210 E. Spillman St. | Gonzales | LA | 70737 | BJVKV7B00 | 226880 | ||||||
Dialysis Systems of Hammond - Davita | 15799 Professional Plaza | Hammond | LA | 70403 | GELLY3100 | 281046 | ||||||
Davita 2294 Marrero Dialysis Center | 1908 Jutland Dr | Harvey | LA | 70058 | 03TC8AQ00 | 1454156 | ||||||
Independent Renal Center - Davita | 12392 Highway 40 | Independence | LA | 70443 | 310DCE700 | 305989 | ||||||
Davita 2605 Kenner | 720 Village Rd | Kenner | LA | 70065 | GD7892J00 | 226882 | ||||||
Davita Kenner Regional Dialysis Center | 200 W. Esplanade Ave Ste 100 | Kenner | LA | 70065 | ETAT2DP00 | 231579 | ||||||
Davita River Parish Dialysis Center # 2231 | 2880 West Airline Highway | La Place | LA | 70068 | A70QJA000 | 1189546 | ||||||
Davita 3535 Lake Charles Southwest Dialysis | 433 Dr Michael Debakey Dr Ste 184 | Lake Charles | LA | 70601 | J8QVPAB00 | 219625 | ||||||
Davita 6318 Lake Charles Southwest At Home Dialysis | 433 Dr Michael Debakey Dr Ste 184 | Lake Charles | LA | 70601 | CDT8XPC00 | 1454043 | ||||||
Davita River Bend Dialysis #5538 | 1057 Paul Maillard Rd | Luling | LA | 70070 | 1GGJ64Q00 | 1682929 | ||||||
Davita Metairie Dialysis Center # 2117 | 7100 Airline Drive | Metairie | LA | 70003 | J46VQ6K00 | 1172699 | ||||||
Davita 6274 Monroe North At Home Dialysis | 2344 Sterlington Rd | Monroe | LA | 71203 | JJNRY2G00 | 1463384 | ||||||
Da Vita Fleur De Lis Dialysis Ctr | 5555 Bullard Ave Ste 110 | New Orleans | LA | 70128 | D7JD7E100 | 210335 | ||||||
Davita - Crescent City Dialysis | 3909 Bienville St. Suite 1b | New Orleans | LA | 70119 | F0MCV7F00 | 230256 | ||||||
Davita - Westbank Chronic Renal Center #630 | 3631 Behrman Pl | New Orleans | LA | 70114 | 468FLYG00 | 210350 | ||||||
Davita 2480 Fleur De Lis Dialysis Center | 5555 Bullard Ave Ste 110 | New Orleans | LA | 70128 | AKT6JEQ00 | 1454260 | ||||||
Davita New Orleans Uptown #2038 | 1401 Foucher Street, 4th Floor | New Orleans | LA | 70115 | 5CL7Q6500 | 227311 | ||||||
Davita Westbank At Home #5928 | 3631 Behrman Pl | New Orleans | LA | 70114 | 9BH64AL00 | 1288828 | ||||||
Memorial Dialysis Center | 4427 South Robertson Street | New Orleans | LA | 70115 | JHWMXM100 | 235905 | ||||||
Davita 6183 Shreveport Hhd Center | 1560 Irvine Pl | Shreveport | LA | 71101 | 5F0XW7K00 | 1418626 | ||||||
Davita Red River Dialysis Center # 4451 | 9205 Linwood Ave | Shreveport | LA | 71106 | H0KWKAR00 | 1720695 | ||||||
Davita - Northshore Kidney Care | 106 Medical Center Drive, Suite 101 | Slidell | LA | 70461 | 3VYAJB000,H567VB500 | 1104891 | ||||||
Davita 6248 Slidell Kidney Care At Home | 1150 Robert Blvd Ste 240 | Slidell | LA | 70458 | F08360W00 | 1454034 | ||||||
Slidell Kidney Care | 1150 Robert Boulevard, Suite 240 | Slidell | LA | 70458 | 85JBCDW00 | 213433 | ||||||
Davita 3537 Sulphur | 944 Beglis Pkwy | Sulphur | LA | 70663 | 5KPDCNQ00 | 276827 | ||||||
Davita Oakwood Dialysis Center #2032 | 148 Hector Avenue | Terrytown | LA | 70056 | 9A4TTX600 | 1216204 | ||||||
Davita 3035 Boston | 660 Harrison Ave Fl First | Boston | MA | 2118 | E6T7EXV00 | 224734 | ||||||
Davita 3056 Brookline | 322 Washington Street | Brookline | MA | 2445 | 21AG3QM00,21AG3QMF1 | 228691 | ||||||
Davita 3573 Burlington Dialysis | 41 Mall Rd | Burlington | MA | 1805 | JCYE9P500,JCYE9P5F1 | 319496 | ||||||
Davita 3238 Northeast Cambridge | 799 Concord Avenue, First Floor | Cambridge | MA | 2138 | 50KTL9C00 | 230774 | ||||||
Davita 3242 Weymouth | 330 Libbey Industrial Pkwy | East Weymouth | MA | 2189 | 27YD93W00,27YD93WF1,GJ473KX00 | 213671 | ||||||
Physicians Dialysis, Inc. - Fitchburg | 551 Electric Avenue | Fitchburg | MA | 1420 | 46QGVW700 | 232980 | ||||||
Davita - Wellington Circle At Home | 10 Cabot Rd Ste 103b | Medford | MA | 2155 | J66FLPK00 | 1413855 | ||||||
Davita - Wellington Dialysis | 10 Cabot Road, Suiet 103 B. | Medford | MA | 2155 | 8L8ABVH00 | 235694 | ||||||
Davita - New Bedford At Home | 524 Union Street | New Bedford | MA | 2740 | 5FRW8BQ00 | 1398222 | ||||||
Davita 3239 New Bedford | 524 Union St. | New Bedford | MA | 2740 | 8Q5H3AX00,BQ5H3AXF1 | 229113 | ||||||
Davita 3313 Salem Northeast | 10 Colonial Road, Suite 205 | Salem | MA | 1970 | 4BH10HE00 | 235534 | ||||||
Davita Wellsley Dialysis | 195 Worchester Street | Wellesley | MA | 2481 | L7E9XEQ00 | 226286 | ||||||
Davita 3243 Woburn | 23 Warren Ave | Woburn | MA | 1801 | W2R8KYF00,W2R8KYFF1 | 219551 | ||||||
Davita #1651 Worcester Dialysis Center | 19 Glennie St. Ste A | Worcester | MA | 1605 | 63873JA00 | 1138134 | ||||||
Davita Aberdeen | 780 W. Bel Air Ave | Aberdeen | MD | 21001 | B6F7DL100 | 1253642 | ||||||
Davita Catonsville | 1581 Sulphur Spring Rd Ste 112 | Arbutus | MD | 21227 | 0CCO5K100,CHQERD100 | 213446 | ||||||
Bertha Sirk Dialysis Center, Inc. | 5820 York Road, Suite 10 | Baltimore | MD | 21212 | XSBS3UP00 | 213674 | ||||||
Davita Mercy Dialysis | 315 N. Calvert St. Ste 300 | Baltimore | MD | 21202 | 35AKW7500 | 213233 | ||||||
Davita #3369 Baltimore Geriatric | 4940 Eastern Avenue, 5th Floor | Baltimore | MD | 21224 | 6FMJ5YT00,KK60A3N00 | 275973 | ||||||
Davita 3262 Jhhs-North Bond St. | 409 Caroline St. | Baltimore | MD | 21231 | K38AQPK00 | 213235 | ||||||
Davita 3323 J. B. Zachary | 333 Cassell Dr Ste 2300 | Baltimore | MD | 21224 | FCLK09500 | 275955 | ||||||
Davita 3324 Whitesquare | 1 Nashua Court, Suite E. | Baltimore | MD | 21221 | A14VT0300 | 278068 | ||||||
Davita 3325 25th Street | 920 East 25th Street | Baltimore | MD | 21218 | H47Y14V00 | 276311 | ||||||
Davita 3367 Howard Street | 22 South Howard Street | Baltimore | MD | 21201 | 9HFKBDD00 | 278167 | ||||||
Davita Carroll County Acutes # 1019-2 Dialysis | 1585 Sulphur Spring Road, Suite 107 | Baltimore | MD | 21227 | AF82QG500 | 234759 | ||||||
Davita Downtown Dialysis Center | 821 N. Eutaw St. Ste 401 | Baltimore | MD | 21201 | 8XTAEOA00 | 210276 | ||||||
Davita Greenspring Dialysis Center | 4701 Mount Hope Drive, Suite C | Baltimore | MD | 21215 | CCC5FTD00 | 225679 | ||||||
Davita Seton Drive Dialysis | 4800 Seton Drive | Baltimore | MD | 21215 | AB0JLWL00 | 1275931 | ||||||
Harford Road Dialysis Center | 5800 Harford Rd | Baltimore | MD | 21214 | ED6A52E00 | 279024 | ||||||
Jb Zachary At Home | 333 Cassell Drive, Suite 2300 | Baltimore | MD | 21224 | DEBV6HK00 | 1199847 | ||||||
Davita 3336 Bel Air | 2225 Old Emmorton Road, Suite 105 | Bel Air | MD | 21015 | L7C72KX00 | 276324 | ||||||
Davita Calverton Dialysis Center # 2499 | 4780 Corridor Pl Ste C | Beltsville | MD | 20705 | BJGT7HR00 | 1486637 | ||||||
Davita #0811 Berlin | 314 Franklin Ave Ste 306 | Berlin | MD | 21811 | 3FD7AT500 | 210278 | ||||||
Renal Care of Bowie | 4861 Telsa Drive, Suite H | Bowie | MD | 20715 | 1B33HWV00 | 320475 | ||||||
Davita | 111 Cherry Hl Road Harbor Park W. | Brooklyn | MD | 21225 | FGNY7E100 | 230056 | ||||||
Davita #2043 | 300 Bryn Street, First Floor | Cambridge | MD | 21613 | 8E6FVCE00 | 1070730 | ||||||
Davita 2513 North Rolling Road Dialysis | 1108 N. Rolling Rd | Catonsville | MD | 21228 | 588EBT300 | 346343 | ||||||
Rtc Chestertown | 100 Brown Street | Chestertown | MD | 21620 | G4KM4VP00 | 232027 | ||||||
Davita 3076 Gwu-Clinton | 10401 Hospital Drive, Suite G-02 | Clinton | MD | 20735 | 3GBK2VB00 | 231474 | ||||||
Davita 3704 Southern Maryland | 9211 Stuart Ln | Clinton | MD | 20735 | 2CPVWLF00 | 231979 | ||||||
Davita 3636 Cedar Lane | 6334 Cedar Ln Ste 101 | Columbia | MD | 21044 | AFWHPMD00 | 280474 | ||||||
Davita Howard County | 5999 Harpers Farm Road, Suite E-110 | Columbia | MD | 21044 | XF4PVEE00 | 210282 | ||||||
Davita 3452 Dundalk | 14 Commerce St. | Dundalk | MD | 21222 | 04AJLP700 | 285273 | ||||||
Davita Easton Dialysis | 402 Marvel Ct | Easton | MD | 21601 | VEKM64P00 | 210286 | ||||||
Davita District Heights Dialysis #4321 | 5701 Silver Hill Rd | Forestville | MD | 20747 | 582HFGR00 | 1463993 | ||||||
Davita Dialysis 3474-1 Frederick Acutes - Frederick Memorial Hospital | 400 W. 7th St. | Frederick | MD | 21701 | FJXBBCT00 | 1463727 | ||||||
Davita Frederick At Home | 140 Thomas Johnson Dr | Frederick | MD | 21702 | D1L3LBY00 | 1435954 | ||||||
Frederick Dialysis - Davita | 140 Thomas Johnson Dr Suite 100 | Frederick | MD | 21702 | H8KP9KR00 | 276287 | ||||||
Davita-Germantown At Home | 20111 Century Blvd | Germantown | MD | 20874 | ADV54JA00 | 1285320 | ||||||
Germantown Dialysis Center #2053 | 20111 Century Boulevard, Suite C | Germantown | MD | 20874 | F89JW0B00 | 347361 | ||||||
Davita 3646 Glem Burnie | 120 Langley Rd N. | Glen Burnie | MD | 21060 | NT1NBFU00 | 210279 | ||||||
Davita Washington County Dialysis #2458 | 1136 Opal Ct | Hagerstown | MD | 21740 | F0266MF00 | 1727551 | ||||||
Davita Tacoma Park Dialysis Center #1617-1 | 1502 University Blvd E. | Hyattsville | MD | 20783 | 455WQCC00 | 1634750 | ||||||
Davita - Lanham At Home | 8855 Annapolis Road, Suite 104 | Lanham | MD | 20706 | 61WN4LF00 | 1283067 | ||||||
Renal Care Management Lanham Dialysis Center | 8855 Annapolis Road, Suite 200 | Lanham | MD | 20706 | E9QMD3F00 | 225951 | ||||||
Davita # 1578 - Kidney Care of Largo | 1300 Mercantile Lane, Suite 194 | Largo | MD | 20774 | VKNWGT700 | 210268 | ||||||
Davita 3759 Landover | 1200 Mercantile Lane, Suite 105 | Largo | MD | 20774 | G81QTV300 | 217757 | ||||||
Davita - Kidney Care Center of Laurel | 14631 Laurel Bowie Rd Suite 100-105 | Laurel | MD | 20707 | 9H5EAXG00 | 213247 | ||||||
Davita 3310 Green Springs | 10753 Falls Road, Suite 115 | Lutherville | MD | 21093 | 6APC73R00 | 275347 | ||||||
Davita - Owings Mills | 10 Cross Road, Suite 110 | Owings Mills | MD | 21117 | 81CJQMG00 | 235556 | ||||||
Rivertowne Dialysis Center At Oxon Hill | 6192 Oxon Hill Rd | Oxon Hill | MD | 20745 | 14KF5MV00 | 277648 | ||||||
Davita 3362 Pasadena | 8894 Fort Smallwood Road, Suite 12-16 | Pasadena | MD | 21122 | C6YQHYL00 | 281176 | ||||||
Pikesville Dialysis Center Davita | 1500 Reisterstown Road, Suite 220 | Pikesville | MD | 21208 | 6D9326300,HB8224800 | 346243 | ||||||
Davita Baltimore County Dialysis | 9635 Liberty Rd Ste A | Randallstown | MD | 21133 | 37R6F9V00 | 220161 | ||||||
Davita #0812 Rockville | 14915 Broschart Road, Suite 100 | Rockville | MD | 20850 | 21JMQPN00 | 210287 | ||||||
Davita 3292 Silver Spring | 8412 Georgia Ave | Silver Spring | MD | 20910 | DAH1T3100 | 277048 |
Page 40 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Renal Care Management | 831 University Boulevard Suite 11 | Silver Springs | MD | 20903 | 2L00KY500 | 277248 | ||||||
Davita #0562 Dulaney Towson Dialysis Center | 113 West Rd Ste 201 | Towson | MD | 21204 | 5E8528600 | 281071 | ||||||
Davita - Carroll County Dialysis Facility | 412 Malcolm Drive, Suite 310 | Westminster | MD | 21157 | LS33IQR00 | 213248 | ||||||
Davita Wheaton Dialysis | 11941 Georgia Avenue, Wheaton Park Shopping Center | Wheaton | MD | 20902 | H1VECMP00 | 235783 | ||||||
Davita Kidney Home (Home Options and Medical Education-Pd) # 1975 | 2245 Rolling Run Dr Ste 4 | Windsor Mill | MD | 21244 | 4718REP00 | 1695254 | ||||||
Davita Northwest Dialysis Center # 2250 | 2245 Rolling Run Dr Ste 1 | Windsor Mill | MD | 21244 | B0AK87K00 | 1428509 | ||||||
Davita- Kidney Home (Home Options and Med Education) Dialysis # 5981 | 2245 Rolling Run Dr Ste 3 | Windsor Mill | MD | 21244 | 269KAAL00 | 1463655 | ||||||
Davita Down River Dialysis Center #1680 | 5600 Allen Road | Allen Park | MI | 48101 | 4H63J7K00 | 285032 | ||||||
Davita Battle Creek Dialysis | 220 Goodale Avenue East | Battle Creek | MI | 49037 | 8JYRVY900 | 1100419 | ||||||
Davita Michigan Kidney Center - Brighton | 7960 West Grand River, Suite 210 | Brighton | MI | 48114 | 31Y8G6W00 | 235258 | ||||||
Davita Burton Dialysis Center # 4415 | 4015 Davison Rd | Burton | MI | 48509 | HKNBWJE00 | 1612806 | ||||||
Davita Chelsea Dialysis | 1620 Commerce Park Drive, Suite 200 | Chelsea | MI | 48118 | 58TGL4B00 | 1233068 | ||||||
Davita #0152 Clarkston Dialysis | 6770 Dixie Highway, Suite 205 | Clarkston | MI | 48346 | KF13CAP00 | 278545 | ||||||
Davita Clinton Township At Home #6232 | 15918 Nineteen Mile Rd. Suite 110 | Clinton Township | MI | 48038 | DFGHXPB00 | 1409900 | ||||||
Davita Commerce Township Dialysis Center | 120 W. Commerce Road | Commerce Township | MI | 48382 | KGE1AB000 | 1279753 | ||||||
Davison Dialysis Center | 1011 South State Road | Davison | MI | 48423 | K3QNKEY00 | 344838 | ||||||
Davita #2160 East Dearborn Dialysis Center | 13200 West Warren Avenue | Dearborn | MI | 48126 | GAMEXE100 | 1220814 | ||||||
Davita 4018 Dearborn-Fka Oakwood | 1185 Monroe | Dearborn | MI | 48124 | RHGSTMV00 | 219382 | ||||||
Davita Dearborn At Home Dialysis # 3989 | 22030 Park St. | Dearborn | MI | 48124 | DJW35PP00,JAQ5NMX00 | 1454301 | ||||||
Davita - Detroit Dialysis | 2674 East Jefferson | Detroit | MI | 48207 | 22C1BD500 | 280350 | ||||||
Davita 3426 Detroit Downtown | 18100 Schaefer Hwy | Detroit | MI | 48235 | 4EC1YMF00 | 236003 | ||||||
Davita 3427 Detroit Redford | 22711 Grand River Ave | Detroit | MI | 48219 | K7GLE4A00,K7GLE4AF0 | 229703 | ||||||
Davita 3428 Detroit Kresge | 4145 Cass Ave | Detroit | MI | 48201 | TFY1LA200 | 229831 | ||||||
Davita 3429 Motor City Dialysis | 4160 John R. St. Ste 724 | Detroit | MI | 48201 | DCLH3MG00 | 228972 | ||||||
Davita Dialysis - Detroit | 6150 Cadieux Road | Detroit | MI | 48224 | GH05CR500 | 281724 | ||||||
Davita Motor City Dialysis #3429-1 | 4727 St. Antoine St. Ste 101 | Detroit | MI | 48201 | H727JGW00 | 1612615 | ||||||
Davita- Grosse Pointe Dialysis | 18000 East Warren Avenue, Suite 100 | Detroit | MI | 48222 | BA2LRGF00 | 1282876 | ||||||
New Center Dialysis, P.C. | 3011 West Grand Boulevard, Suite 650 | Detroit | MI | 48202 | GK7221C00 | 231824 | ||||||
Davita 6207 Lansing At Home | 1675 Watertower Pl Suite 700 | East Lansing | MI | 48823 | 2D0APCQ00 | 1422740 | ||||||
Davita - Fenton Dialysis | 17420 Silver Parkway | Fenton | MI | 48430 | 5LQ718W00 | 1252733 | ||||||
Davita - Flint Dialysis Center #1557 | 2 Hurley Plaza, Suite 115 | Flint | MI | 48503 | DLB3MEC00 | 346901 | ||||||
Davita Ballenger Pointe #2104 | 2262 South Ballenger Highway | Flint | MI | 48503 | A844YXL00 | 1129793 | ||||||
Davita Ballenger Pointe At Home #6011 | 2262 South Ballenger Highway | Flint | MI | 48503 | 09FK13C00 | 1137972 | ||||||
Hallwood Dialysis Center #1558 | 4929 Clio Road, Suite B. | Flint | MI | 48504 | D4J4GK400 | 346899 | ||||||
Park Plaza Dialysis Center | G-1075 North Ballenger Highway | Flint | MI | 48504 | G2Q7DC400 | 346900 | ||||||
Davita #0298 Flushing Dialysis | 3469 Pierson Pl Ste A | Flushing | MI | 48433 | HDXF7W900 | 320621 | ||||||
Davita 3634 Newaygo County | 1317 W. Main St. | Fremont | MI | 49412 | 301TGQ300 | 346139 | ||||||
Davita Grand Blanc Dialysis | 3625 Genesys Parkway | Grand Blanc | MI | 48439 | FHEBGDE00 | 276364 | ||||||
Davita Grand Haven | 16964 Robbins Road | Grand Haven | MI | 49417 | 6AY3XQ400 | 276973 | ||||||
Davita - Grand Rapids | 801 Cherry St. Se | Grand Rapids | MI | 49506 | 8KKQJYJ00 | 276970 | ||||||
Davita - Grand Rapids At Home | 801 Cherry Street Southeast, 2nd Floor | Grand Rapids | MI | 49506 | EHTA2CC00 | 1216147 | ||||||
Davita Grand Rapids East | 1230 Ekhart Street Northeast | Grand Rapids | MI | 49503 | B1XBC0W00 | 285259 | ||||||
Davita Dialysis - Highland Park | 64 Victor Street | Highland Park | MI | 48203 | 7JAL3QE00 | 277102 | ||||||
Davita State Fair Dialysis #1592 | 19800 Woodward Ave | Highland Park | MI | 48203 | 8LT9MEV00 | 280453 | ||||||
Davita Ionia Dialysis Center | 2622 Heartland Boulevard | Ionnia | MI | 48846 | L0V09PE00 | 1265874 | ||||||
Davita Jackson Dialysis Center | 234 West Louis Glick Highway | Jackson | MI | 49201 | JDQHRE800,K80D99N00 | 277104 | ||||||
Davita Kalamazoo Central | 535 S. Burdick, Suite 110 | Kalamazoo | MI | 49007 | A4M2MJ700 | 1276903 | ||||||
Davita Kalamazoo West #2287 | 1040 N. 10th Street | Kalamazoo | MI | 49009 | 94V3ERG00 | 1276987 | ||||||
Davita- Kalamazoo Home Hemo #6195 | 1040 North 10th Street | Kalamazoo | MI | 49009 | JLP3XB400 | 1283019 | ||||||
Davita 3071 Ludington | 5 N. Atkinson Dr Ste 101 | Ludington | MI | 49431 | HHPG9EQ00 | 277573 | ||||||
Davita 3069 Muskegon | 1277 Mercy Dr | Muskegon | MI | 49444 | JJETWMR00 | 276974 | ||||||
Davita 6314 Muskegon At Home | 1277 Mercy Dr. | Muskegon | MI | 49444 | FCRN84H00 | 1405113 | ||||||
Novi Kidney Center | 47250 West Ten Mile Road | Novi | MI | 48374 | 52P78Q100 | 232130 | ||||||
Oak Park Dialysis Center #369, Parkwood Plaza | 13481 West Ten Mile Road | Oak Park | MI | 48237 | 77Y28RD00 | 347021 | ||||||
Davita North Oakland Dialysis Facility | 450 N. Telegraph Rd Suite 600 | Pontiac | MI | 48341 | 2J0JKG400 | 209127 | ||||||
Davita- North Oakland Medical Center # 1066-1 Dialysis-Acute | 461 W. Huron St. Rm 509 | Pontiac | MI | 48341 | 0163Y4C00 | 1463313 | ||||||
Davita Rochester Hills Dialysis Center #2105 | 1886 W. Auburn Rd Ste 100 | Rochester Hills | MI | 48309 | 65YWFG000 | 1177503 | ||||||
Davita 3561 Romulus | 31470 Ecorse Rd | Romulus | MI | 48174 | AJ2PN4B00 | 319271 | ||||||
Saginaw Dialysis Clinic | 1527 East Genesee | Saginaw | MI | 48607 | L59XGEQ00 | 282174 | ||||||
Davita #2464 | 24467 W. 10 Mile Rd | Southfield | MI | 48033 | D4YLWNJ00 | 1623981 | ||||||
Davita 3507 Southfield | 18544 Eight Mile Road | Southfield | MI | 48075 | JCD9D9300 | 319191 | ||||||
Davita Cornerstone Dialysis At Home #6004 | 23857 Greenfield Road | Southfield | MI | 48075 | 9ENB4RG00 | 1100493 | ||||||
Southfield Dialysis Center #329 | 23857 Greenfield Rd | Southfield | MI | 48075 | L540NVC00 | 209125 | ||||||
Southfield West Dialysis Center #295 | 21900 Melrose, Southfield Tech Center, Building #2 | Southfield | MI | 48075 | 5B22N5C00 | 345184 | ||||||
Davita 4219 Southgate | 14752 Northline Rd | Southgate | MI | 48195 | K4MD5E600 | 227045 | ||||||
Macomb Kidney Center of Davita #326 | 28295 Schoenherr Road, Suite A | Warren | MI | 48088 | 9FQRHBX00 | 229102 | ||||||
Davita Waterford Tel Huron Dialysis #2463 | 225 Summit Dr | Waterford | MI | 48328 | J6XCPXK00 | 1488238 | ||||||
Davita West Bloomfield #0297 | 6010 W. Maple Rd Ste 215 | West Bloomfield | MI | 48322 | 35WB2EV00 | 1617075 | ||||||
Davita West Bloomfield At Home #5943 | 6010 W. Maple Rd Ste 215 | West Bloomfield | MI | 48322 | 78GN2TD00 | 1644416 | ||||||
Davita 4214 Westland | 5715 N. Venoy Rd | Westland | MI | 48185 | 1B1XV5A00 | 233480 | ||||||
Davita Westland Dialysis Center #2102 | 36585 Ford Road | Westland | MI | 48185 | 28MR6MF00 | 1116322 | ||||||
Davita Ypsilanti At Home | 2766 Washtenaw Rd | Ypsilanti | MI | 48197 | 05QR5MD00 | 1448592 | ||||||
Ypsilanti Dialysis Center -Davita | 2766 Washtenaw, Washetenaw Fountain Plaza | Ypsilanti | MI | 48197 | LL0LL8K00 | 277077 | ||||||
Davita - Arden Hills Dialysis | 3900 Northwoods Drive, Suite 110 | Arden Hills | MN | 55112 | CIHQH9R00 | 213274 | ||||||
Davita | 8591 Lyndale Avenue South | Bloomington | MN | 55420 | 456Y4XE00 | 281079 | ||||||
Davita Burnsville Dialysis | 501 East Nicollet, Suite 150 | Burnsville | MN | 55337 | SQLU3GG00 | 210178 | ||||||
Davita Cass Lake Dialysis | 602 Grand Utley Street | Cass Lake | MN | 56633 | 0BHRIAB00 | 216792 | ||||||
Davita Cottage Grove Dialysis | 8800 East Point Douglas Road, Suite 100 | Cottage Grove | MN | 55016 | G9RG05100 | 1233116 | ||||||
Davita Dialysis Eagan #2041 | 2750 Blue Water Road, Suite 300 | Eagan | MN | 55121 | A72YQ7E00 | 1079056 | ||||||
Eden Prairie Dialysis Center #2042 | 14852 Scenic Heights Road, Suite 255 | Eden Prairie | MN | 55344 | HDXC70A00 | 347360 | ||||||
Davita #0215 Faribault Dialysis | 201 S. Lyndale Ave Ste F. | Faribault | MN | 55021 | CAQ8C2Y00 | 221767 | ||||||
Davita - Forest Lake Dialysis Unit | 1068 South Lake Street | Forest Lake | MN | 55025 | A99JRJL00 | 233407 | ||||||
Davita-Fridley Dialysis | 5301 East River Road , Suite 117 | Fridley | MN | 55421 | G9MQVA600 | 1282903 | ||||||
Davita #1964 - Maple Grove Pd At Home Dialysis | 15655 Grove Cir N. | Maple Grove | MN | 55369 | KJ2EFEC00 | 1463316 | ||||||
Davita 2479 Maple Grove Dialsis | 15655 Grove Cir N. | Maple Grove | MN | 55369 | 0GGQ73W00 | 1422779 | ||||||
Maplewood Dialysis Davita | 2785 White Bear Avenue | Maplewood | MN | 55109 | 7FRCPT700 | 227954 | ||||||
Marshall Dialysis of Total Renal Care | 300 South Bruce Street | Marshall | MN | 56258 | KWY4SNX00 | 213542 | ||||||
Davita # 0207 Minneapolis Dialysis Center | 825 South 8th Street, Suite Sl42 | Minneapolis | MN | 55404 | EL0QIRY00 | 210198 | ||||||
Davita #0205 | 6550 York Avenue South, Suite 100 | Minneapolis | MN | 55435 | 8AWPNOE00 | 213540 | ||||||
Davita - North Central Acute Dialysis # 224 | 901 S. 6th St. Suite R7100 | Minneapolis | MN | 55415 | FF5JWCQ00 | 1468261 | ||||||
Davita Coon Rapids Dialysis | 3960 Coon Rapids Blvd Nw Ste 309 | Minneapolis | MN | 55433 | DB763MQ00 | 210179 | ||||||
Davita Home Dialysis | 825 South Eighth Street, Suite 1224 | Minneapolis | MN | 55404 | 35JDR8300 | 232258 | ||||||
Davita Uptown Dialysis | 3601 Lyndale Avenue S. | Minneapolis | MN | 55409 | 42T2WKH00 | 1272126 | ||||||
Davita-North Memorial Apheresis #227-14-Acute | 3300 Oakdale Ave N. | Minneapolis | MN | 55422 | 96X35TD00 | 1478657 | ||||||
Minneapolis North East Hennepin Dialysis | 1049 10th Avenue South East | Minneapolis | MN | 55414 | B7DLH1Y00 | 320625 | ||||||
Davita Minnetonka Dialysis Unit | 17809 Hutchins Drive | Minnetonka | MN | 55345 | 3EDMP7C00 | 231460 | ||||||
Montevideo Dialysis Davita | 824 North 11th Street | Montevideo | MN | 56265 | RQT8WCQ00 | 227976 | ||||||
New Hope Dialysis Center #2200 | 5640 International Parkway | New Hope | MN | 55428 | 8ED636E00 | 1173020 | ||||||
Davita Pine City Dialysis | 129 East 6th Avenue | Pine City | MN | 55063 | 4Y2CMWY00 | 230792 | ||||||
Davita - Pipestone Dialysis Center | 911 5th Ave Sw | Pipestone | MN | 56164 | 3E5F2EH00 | 274929 | ||||||
Red Wing Dialysis Center | 3028 North Service Drive | Red Wing | MN | 55066 | 9FGLA6500 | 213544 | ||||||
Redwood Falls Dialysis Davita | 100 Fallwood Road | Redwood Falls | MN | 56283 | 611290JF0 | 228898 | ||||||
Davita Richfield Dialysis Center #2175 | 6601 Lyndale Avenue, Suite 150 | Richfield | MN | 55423 | KLD6KJR00 | 1173025 | ||||||
Davita Richfield Pd Program #2232 | 6601 Lyndale Avenue, Suite 150 | Richfield | MN | 55423 | F68QMW100 | 1192892 | ||||||
Davita North Memorial Health Care # 226-1 | 3300 Oakdale Ave N. | Robbinsdale | MN | 55422 | 63HNJQM00 | 1474652 | ||||||
Davita Scott County | 7456 South Park Drive | Savage | MN | 55378 | DH3G5L300 | 1233082 | ||||||
Davita St. Louis Park Pd | 3505 Louisiana Avenue | St. Louis | MN | 55426 | 3BLY84900 | 1220468 | ||||||
Davita St. Louis Park Dialysis | 3505 Louisiana Ave S. | St. Louis Park | MN | 55426 | 0560PAA00 | 323958 | ||||||
Davita Westwood Hills #2428 | 7525 Wayzata Blvd | St. Louis Park | MN | 55426 | 4KG86TB00 | 1423434 | ||||||
Davita 5996 University Unit Riverside At Home | 1045 Westgate Dr Ste 90 | St. Paul | MN | 55114 | 70G7B8D00 | 1457767 | ||||||
Davita Capital Dialysis | 555 Park Street, Suite 230 | St. Paul | MN | 55103 | FGQNCK400 | 235296 |
Page 41 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita Capitol Pd Program #1748 Dba: Capitol Home Dialysis | 555 Park Street, Suite 110 | St. Paul | MN | 55103 | 1L5C56E00,6EYFG6J00 | 275899 | ||||||
Davita Highland Park Dialysis | 1559 7th St. W. | St. Paul | MN | 55102 | EG65LXN00 | 1423625 | ||||||
Davita Home Unit # 6009 | 555 Park St. Ste 230a | St. Paul | MN | 55103 | 6GXN13A00 | 1252658 | ||||||
Davita St. Paul Dialysis | 555 Park Street, Suite 180 | St. Paul | MN | 55103 | 34JCX7600 | 213727 | ||||||
Davita Sun Ray Dialysis Center | 1758 Old Hudson Rd Suite 100 | St. Paul | MN | 55106 | F6TH4BA00 | 1423627 | ||||||
Davita University Dialysis Center Riverside | 1045 Westgate Dr Ste 90 | St. Paul | MN | 55114 | G8APH9D00 | 232253 | ||||||
Davita Woodbury Dialysis | 1850-3 Weir Drive | St. Paul | MN | 55125 | A54E4KL00 | 235294 | ||||||
River City Dialysis Center | 1970 Northwestern Avenue North | Stillwater | MN | 55082 | 07JDA2F00 | 235295 | ||||||
Regional Kidney Disease Program of Total Renal Care, Dba: West St. Paul Dialysis | 1555 Livingston | West St. Paul | MN | 55118 | OYBYXOG00 | 213728 | ||||||
Davita 3523 Cameron | 1003 West 4th Street | Cameron | MO | 64429 | J3JG1K600 | 280833 | ||||||
Davita Dialysis St. Louis Acutes - St. Lukes Rehab Hospital # 1103-4 | 14709 Olive Blvd | Chesterfield | MO | 63017 | 1CRAYJV00 | 1464202 | ||||||
Davita 3525 Chillicothe | 588 E. Business 36 | Chillicothe | MO | 64601 | DJQXY2J00 | 281702 | ||||||
Davita Columbia At Home | 1701 E. Broadway, Suite G102 | Columbia | MO | 65201 | B41KCBN00 | 1275965 | ||||||
Davita Columbia Dialysis Center # 2136 | 1701 East Broadway Suite G102 | Columbia | MO | 65201 | 16Y4JJB00 | 1169921 | ||||||
Crestwood Dialysis Center #1576 | 9901 Watson Road, Suite 125 | Crestwood | MO | 63126 | 9KBRGEP00 | 277054 | ||||||
Davita 3465 St. Louis West Pd Dialysis | 450 N. Lindbergh Blvd Suite 100c | Creve Coeur | MO | 63141 | 34YB37QF0 | 314891 | ||||||
Davita Crystal City Dialysis | Highway 61 South and I. 55 | Crystal City | MO | 63019 | 54M9H0L00 | 213279 | ||||||
Davita Dexter Dialysis Center #4447 | 2010 N. Outer Rd | Dexter | MO | 63841 | G10EW5W00 | 1608763 | ||||||
Davita Eureka Dialysis Center #2445 | 419 Meramec Blvd | Eureka | MO | 63025 | 69BCHFY00 | 1409974 | ||||||
Davita Maple Valley Plaza Dialysis Center #5010 | 649 Maple Valley Dr Bldg G. | Farmington | MO | 63640 | K8NVJ2V00 | 1661269 | ||||||
Davita - North St. Louise County Dialysis Center | 13119 New Halls Ferry Road | Florissant | MO | 63033 | JHDBDPQ00 | 1285205 | ||||||
Davita 3279 Florissant | 11687 West Florissant | Florissant | MO | 63033 | DCG49EW00 | 275251 | ||||||
Davita North St. Louis County At Home #5938 | 13119 New Halls Ferry Rd | Florissant | MO | 63033 | 9BACCDV00 | 1660874 | ||||||
Davita Hannibal At Home # 5947 | 3140 Palmyra Rd | Hannibal | MO | 63401 | J1T6NRX00 | 1624143 | ||||||
Davita Hannibal Dialysis # 5518 | 3140 Palmyra Rd | Hannibal | MO | 63401 | GF16TKF00 | 1624142 | ||||||
Davita 3499 Hazelwood | 637 Dunn Road, Suite 125 | Hazelwood | MO | 63042 | AC3EG2L00 | 312193 | ||||||
Davita - Eastland Dialysis Center | 19101 East Valley View Pkwy., Suite E. | Independence | MO | 64055 | 7LGG48000 | 1285284 | ||||||
Davita 3202 Hospital Hill | 2250 Holmes | Kansas City | MO | 64108 | 0GEJTGM00 | 233256 | ||||||
Davita 3591 Platte Woods | 7667 Northwest Prairie View Road | Kansas City | MO | 64151 | 0F2BGX500 | 319911 | ||||||
Davita Timberlake Dialysis | 12110 Holmes Rd | Kansas City | MO | 64145 | 5CKAF8Y00 | 1608963 | ||||||
Hope Again Dialysis | 1207 State Route V.V. | Kennett | MO | 63857 | 4CJYN6Q00 | 221850 | ||||||
Davita #5964 At Home | 202 Brevco Plz | Lake St. Louis | MO | 63367 | CDBX88D00 | 1693313 | ||||||
Davita 3516 Lake St. Louis | 201 Brevco Plz | Lake St. Louis | MO | 63367 | 1DVDJGL00 | 229410 | ||||||
Davita 3504 Liberty Dialysis Center | 2525 Glenn Hendren Drive | Liberty | MO | 64068 | 96U0P9700 | 213666 | ||||||
Davita 3531 Nodaway County Dialysis | 2613 South Main | Maryville | MO | 64468 | FEH1JKE00 | 281703 | ||||||
Davita Northland | 2750 Clay Edwards Drive, Suite 100 | North Kansas City | MO | 64116 | 3HMM1A300,YWGSBFS00 | 210133 | ||||||
Davita Northland At Home | 2750 Clay Edwards Drive, Suite 504 | North Kansas City | MO | 64116 | H4FY37800 | 1255963 | ||||||
Davita Waterbury Dialysis #4463 | 929 Waterbury Falls Dr | O Fallon | MO | 63368 | G3MCVEQ00 | 1620850 | ||||||
Davita - Bluff City Dialysis | 2400 Lucy Lee Parkway, Suite E. | Poplar Bluff | MO | 63901 | NQ9P0BM00 | 213287 | ||||||
Davita- Bluff City At Home Dialysis # 5978 | 2400 Lucy Lee Pkwy Ste E. | Poplar Bluff | MO | 63901 | 32A6TKY00 | 1463653 | ||||||
Davita Riverside Reprocessing #3674 | 410 Nw Business Park Ln | Riverside | MO | 64150 | D047CYY00 | 1468263 | ||||||
Davita-Kansas City Mo, Acutes #3635-1 Dialysis | 408 Nw Business Park Ln | Riverside | MO | 64150 | 79EMAE400 | 1220947 | ||||||
Davita 3115 Rolla | 1503 East 10th Street | Rolla | MO | 65401 | RIOO8A300 | 222601 | ||||||
Davita 3335 St. Charles | 2125 Bluestone Dr | St. Charles | MO | 63303 | 147M7TY00 | 275957 | ||||||
Davita 3536 St. Joseph | 5514 Corporate Drive, Suite 100 | St. Joseph | MO | 64507 | 95R2P8400 | 280836 | ||||||
Davita St. Joseph At Home | 5514 Corporate Drive, Suite 100 | St. Joseph | MO | 64507 | LLOPG2D00 | 1270082 | ||||||
Davita - Lamplighter Dialysis Center #2051 | 12654 Lamplighter Square | St. Louis | MO | 63128 | C2349PJ00 | 1080211 | ||||||
Davita 3386 Shrewsbury | 7435 Watson Road, Suite 119 | St. Louis | MO | 63119 | 10MFFCT00 | 277247 | ||||||
Davita 3418 Washington Univ Jv | 400 North Lindbergh Boulevard | St. Louis | MO | 63141 | 34YB37Q00 | 281713 | ||||||
Davita 3475 St. Louis Washington Univ | 324 Debaliveire Avenue | St. Louis | MO | 63112 | JJCYVGN00 | 213289 | ||||||
Davita Dialysis - Missouri Acute Program #459 | 9700 Mackenzie Rd Ste 225 | St. Louis | MO | 63123 | 78CJ79Q00 | 1473135 | ||||||
Davita Dialysis Missouri Acute-Kindred Hospital # 459-25 | 4930 Lindell Blvd | St. Louis | MO | 63108 | 1JJ8R8A00 | 1464256 | ||||||
Davita Hampton Dialysis # 2025. | 1425 Hampton Avenue | St. Louis | MO | 63139 | DGFYL6X00 | 347365 | ||||||
Davita St. Louis West At Home Dialysis | 450 N. Lindberg Blvd Ste 100c | St. Louis | MO | 63141 | E2Q55BR00 | 1279411 | ||||||
Davita Villa of St. John Dialysis Center #4468 | 9030 St. Charles Rock Rd | St. Louis | MO | 63114 | BDV44TK00 | 1662332 | ||||||
Davita-South County Dialysis | 4145 Union Road | St. Louis | MO | 63129 | 2VR9NVF00 | 280304 | ||||||
Renal Treatment Center - St. Louis | 2610 Clark Avenue | St. Louis | MO | 63103 | 9JKI87900 | 210134 | ||||||
Davita- South County Deaconess At Home | 4145 Union Road | St. Louise | MO | 63129 | 1AFB48D00 | 1282912 | ||||||
Davita 3589 St. Peters | 300 First Executive Avenue, Suite A | St. Peters | MO | 63376 | 4K8LN2600 | 345204 | ||||||
Davita 3278 Washington | 1112 Washington Square | Washington | MO | 63090 | 12PWWL500 | 275079 | ||||||
Davita Villa of Wentzville # 4461 | 1126 W. Pearce Blvd Ste 118 | Wentzville | MO | 63385 | GFG5LCD00 | 1624062 | ||||||
Davita 2625 Lucedale | 652 Manilla St. | Lucedale | MS | 39452 | 1GWL8RX00 | 276085 | ||||||
Davita Ocean Springs At Home #6269 | 13150 Ponce De Leon | Ocean Springs | MS | 39564 | 3B9FT6100 | 1275881 | ||||||
Davita Ocean Springs Dialysis | 13150 Ponce De Leon | Ocean Springs | MS | 39564 | AB976QX00 | 1249914 | ||||||
Davita Ocean Springs Dialysis | 12 Marks Road | Ocean Springs | MS | 39564 | 82ZFB0Z00 | 210158 | ||||||
Davita | 4907 Telephone Rd | Pascagoula | MS | 39567 | 5CDN0TA00 | 210161 | ||||||
Davita Ahoskie Dialysis | 129 Hertford County High Road | Ahoskie | NC | 27910 | A5Q7PJK00 | 227958 | ||||||
Davita 1057-3 Asheville Acute Warehouse Dialysis | 400 Ridgefield Ct Suite 101 | Asheville | NC | 28806 | B59CMPC00 | 1454443 | ||||||
Davita 6134 Asheville Kidney At Home | 1600 Centerpark Dr | Asheville | NC | 28805 | 2100DXD00 | 1422622 | ||||||
Davita Asheville Kidney Center | 1600 Centrepark Drive | Asheville | NC | 28805 | 0KKH9HB00 | 209929 | ||||||
Davita Asheville Kidney Center | 1600 Centrepark Drive | Asheville | NC | 28805 | 10798 | |||||||
Davita Montgomery Dialysis Center #578 | 323 West Main Street | Biscoe | NC | 27209 | DDACPJK00 | 1196735 | ||||||
Davita #0589 Burgaw Dialysis Center | 704 South Dickerson St. | Burgaw | NC | 28425 | Q6CX8T600 | 219160 | ||||||
Davita #0944 Burlington Dialysis Center | 873 Heather Rd | Burlington | NC | 27215 | 2JVLGL200 | 227449 | ||||||
Davita Burlington At Home Dialysis #5958 | 873 Heather Rd | Burlington | NC | 27215 | F7K9KRQ00 | 1608764 | ||||||
Davita Carthage Dialysis Center #4493 | 165 Savannah Garden Dr | Carthage | NC | 28327 | 47AP12D00 | 1699991 | ||||||
Chadbourn Dialysis Center | 210 East Strawberry Boulevard | Chadbourn | NC | 28431 | CEAB1T500 | 344533 | ||||||
Charlotte At Home # 6045 | 2321 West Morehead Street | Charlotte | NC | 28208 | 41TAC1L00,AAJ280D00 | 1199848 | ||||||
Davita | 2321 W. Morehead St. Ste 102 | Charlotte | NC | 28208 | POIJGLF00 | 220413 | ||||||
Davita 3568 Charlotte East | 3204 North Sharon Amity Road | Charlotte | NC | 28205 | 3J7G7XD00 | 344461 | ||||||
Davita 3934 South Charlotte | 6450 Bannington Rd | Charlotte | NC | 28226 | 1C0B2XN00 | 220410 | ||||||
Davita 3944 North Charlotte Dialysis | 6620 Old Statesville Rd | Charlotte | NC | 28269 | J95CXPV00 | 1423428 | ||||||
Davita - Cherokee Dialysis Center | 53 Echota Church Road | Cherokee | NC | 28719 | 62TXALT00 | 280829 | ||||||
Davita - Waynesville Dialysis Center #2000 | 11 Park Terrace Drive | Clyde | NC | 28721 | LHAYRLM00 | 346437 | ||||||
Davita - Copperfield Dialysis Center #2004 | 1030 Vinehaven Drive | Concord | NC | 28025 | 5DAWAA800 | 347366 | ||||||
Davita Harrisburg Dialysis Center # 4431 | 3310 Perry St. | Concord | NC | 28027 | 5JKVB9N00 | 1487929 | ||||||
Davita -Durham West At Home | 4307 Western Park Pl Suite 101 | Durham | NC | 27705 | F2HTJ5F00 | 1282648 | ||||||
Davita 3024 Durham | 601 Fayetteville St. | Durham | NC | 27701 | 5R8HVM200 | 213326 | ||||||
Davita 3503 Durham West | 4307 Western Park Pl | Durham | NC | 27705 | 837NG5Q00 | 319267 | ||||||
Dialysis Care of Rockingham County | 251 West King’s Highway | Eden | NC | 27288 | 65QF5CX00 | 213327 | ||||||
Davita 3907 Edenton | 703 Luke St. | Edenton | NC | 27932 | THQF9PD00 | 219821 | ||||||
Davita Albermarle Hospital #2908-1 Dialysis-Acute | 1144 N. Road St. | Elizabeth City | NC | 27909 | J9YH6KX00 | 1483657 | ||||||
Davita Elizabeth City Dialysis | 1840 W. City Dr | Elizabeth City | NC | 27909 | 20G8J5E00 | 219820 | ||||||
Davita #0590 Elizabethtown | 101 Dialysis Drive | Elizabethtown | NC | 28337 | 5DE7E8P00 | 229459 | ||||||
Dialysis Care of Rutherford County | 226 Commercial Drive | Forest City | NC | 28043 | 2795AEB00 | 227022 | ||||||
Davita 3033 Goldsboro | 2609 Hospital Rd | Goldsboro | NC | 27534 | 0ET7FE700 | 213328 | ||||||
Davita 3207 Goldsboro South | 1704 Wayne Memorial Dr | Goldsboro | NC | 27534 | A9PPV6Y00 | 234774 | ||||||
Davita Goldsboro At Home # 6322 | 2609 Hospital Rd | Goldsboro | NC | 27534 | D9114KC00 | 1486066 | ||||||
Dialysis Care of Richmond # 580 | 771 Cheraw Rd | Hamlet | NC | 28345 | D1WSYQQ00 | 213331 | ||||||
Davita Vance County Dialysis #3906 | 854 S. Beckford Dr | Henderson | NC | 27536 | 01JBM0H00 | 213332 | ||||||
Davita Hendersonville Dialysis Center | 500 Beverly Hanks Ctr | Hendersonville | NC | 28792 | F5YWNQR00 | 226683 | ||||||
Davita #0591 Jacksonville | 14 Office Park Dr | Jacksonville | NC | 28546 | JKNTRMW00 | 213560 | ||||||
Davita 6246 Sedc Jacksonville At Home Dialysis | 14 Office Park Dr | Jacksonville | NC | 28546 | 708NRTM00 | 1453924 | ||||||
Davita - Dialysis Care of Kannapolis At Home | 1607 North Main Street | Kannapolis | NC | 28081 | K8CY29D00 | 1398223 | ||||||
Dialysis Care of Kannapolis | 1607 North Main Street | Kannapolis | NC | 28081 | BA7X2G700 | 274930 | ||||||
Davita #0592 | 305 Beasley St. | Kenansville | NC | 28349 | 0DDZF1500 | 213561 | ||||||
Davita - Dialysis Care of Franklin County | 1706 Highway 39 North | Louisburg | NC | 27549 | E0QM2B300 | 227863 | ||||||
Davita # 0409 Madison Dialysis Center | 302 Highway St. Ste 105 | Madison | NC | 27025 | 60B4L4A00 | 344612 | ||||||
Davita Mcdowell County Dialysis Center | 100 Spaulding Rd Ste 2 | Marion | NC | 28752 | 84JXYQG00 | 1133874 | ||||||
Davita #3953 | 7260 E. Marshville Blvd | Marshville | NC | 28103 | 96D6VMF00 | 1458994 | ||||||
Davita Union City | 701 E. Roosevelt Blvd Ste 400 | Monroe | NC | 28112 | JY2SK5000 | 220414 |
Page 42 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita 3061 Mount Olive | 105 Michael Martin Drive | Mount Olive | NC | 28365 | KWAGX7A00 | 228948 | ||||||
Davita - Smokey Mountain | 1611 Andrews Rd | Murphy | NC | 28906 | A1MK2K300 | 1246354 | ||||||
Dialysis Care of Moore | #16 Regional Drive | Pinehurst | NC | 28374 | D6XNVIG00 | 213343 | ||||||
Dialysis Care of Moore County At Home #6006 | 16 Regional Drive | Pinehurst | NC | 28374 | FA6704600 | 1100203 | ||||||
Davita- Dialysis Care of Hoke County | 403 S. Main St. | Raeford | NC | 28376 | 9A14W1L00 | 229403 | ||||||
Davita Wake Forest At Home #5944 | 11001 Ingleside Pl | Raleigh | NC | 27614 | 0KATJ5B00 | 1634769 | ||||||
Davita Wake Forest Dialysis Center #4333 | 11001 Ingleside Pl | Raleigh | NC | 27614 | GBN3BPH00 | 1634751 | ||||||
Davita Reidsville #2049 | 1307 Freeway Drive | Reidsville | NC | 27320 | HDX2XND00 | 1104683 | ||||||
Davita Reidsville At Home | 1307 Freeway Drive | Reidsville | NC | 27320 | 2A05K2300 | 1272653 | ||||||
Davita 3034 Roxboro | 718 Ridge Rd | Roxboro | NC | 27573 | 97LTKFT00 | 224878 | ||||||
Davita Acute Dialysis #583-1 At Rutherford Hospital | 288 S. Ridgecrest Ave Floor 2 | Rutherfordton | NC | 28139 | EDYL2HT00 | 1473130 | ||||||
Dialysis Care of Rowan County #582 | 111 Dorset Drive | Salisbury | NC | 28144 | 34QGXGQ00 | 213347 | ||||||
Davita ??? Southeastern Dialysis Center Shallotte | 4770 Shallotte Ave | Shallotte | NC | 28470 | 7GCH0YE00 | 229618 | ||||||
Davita - Greene County | 1025 Kingold Boulevard | Snow Hill | NC | 28580 | 3GE447C00 | 1252623 | ||||||
Southern Pines Dialysis Center | 209 Windstar Pl | Southern Pines | NC | 28387 | 7KNTWX000 | 1096181 | ||||||
Davita Southport Dialysis Center #4448 | 1513 N. Howe St. Suite 15 | Southport | NC | 28461 | JCXNHLH00 | 1496575 | ||||||
Davita- Mayland Dialysis | 575 Altapass Highway | Spruce Pine | NC | 28777 | H9QJ5NR00 | 1288912 | ||||||
Davita St. Paula Dialysis | 564 Mclean Street | St. Paul | NC | 28384 | 3D79TF400 | 1250066 | ||||||
Davita Swannanoa Dialysis Center #1508 | 2305 Us Highway 70 | Swannanoa | NC | 28778 | C606GDH00 | 345205 | ||||||
Sylva Dialysis Center | 655 Asheville Highway | Sylva | NC | 28779 | D5JHNAF00 | 213749 | ||||||
Dialysis Care of Edgecombe County | 3206 Western Boulevard | Tarboro | NC | 27886 | L8M3VYB00 | 228252 | ||||||
Davita # 0571 | 923 East Caswell Street | Wadesboro | NC | 28170 | BC9D8TA00 | 221999 | ||||||
Davita-Wallace Dialysis #2447 | 5650 South Hwy 41 | Wallace | NC | 28466 | H92RETQ00 | 1398175 | ||||||
Davita Weaverville Dialysis | 329 Merrimon Avenue | Weaverville | NC | 28787 | 4C1EPWG00 | 281735 | ||||||
Davita #0594 | 608 Pecan Ln | Whiteville | NC | 28472 | 541JSPA00 | 209915 | ||||||
Dialysis Care of Martin County | 100 Medical Drive | Williamston | NC | 27892 | E49YKR000 | 231721 | ||||||
Davita #0595 | 2215 Yaupon Dr | Wilmington | NC | 28401 | 2JG3WXX00 | 209925 | ||||||
Davita Wilimington At Home | 2215 Yaupon Drive | Wilmington | NC | 28401 | 9C3BQC100 | 1276042 | ||||||
Davita 3032 Wilson | 1605 Medical Park Dr | Wilson | NC | 27893 | 5HPW2DM00 | 209928 | ||||||
Davita 3588 Forest Hills | 2693 Forest Hills Rd | Wilson | NC | 27893 | 63H3G4D00 | 1077237 | ||||||
Davita- Fargo At Home # 5982 Dialysis | 4474 23rd Ave S. Ste M. | Fargo | ND | 58104 | 960LFWB00 | 1463652 | ||||||
Davita-Fargo | 4474 23rd Ave South, Suite M. | Fargo | ND | 58104 | 759N42E00 | 1279771 | ||||||
Davita 2466 Oakes Dialysis Center | 413 S. 7th St. | Oakes | ND | 58474 | 80HFEBT00 | 1463382 | ||||||
Davita Dodge County Dialysis # 3530 | 1949 E. 23rd Street Ave S. | Fremont | NE | 68025 | B1F6NRB00 | 277244 | ||||||
Davita Grand Island Dialysis | 603 South Webb Road | Grand Island | NE | 68803 | K6EK9HE00 | 278551 | ||||||
Hastings Dialysis Center #1601 | 1900 North St. Joseph Avenue | Hastings | NE | 68901 | T9G2XP600 | 209024 | ||||||
Davita - Capital City Dialysis Center #1602 | 307 North 46th Street | Lincoln | NE | 68503 | 51N9QYQ00 | 209023 | ||||||
Davita Capital City At Home | 307 N. 46th Street | Lincoln | NE | 68503 | JAY8E1E00 | 1269259 | ||||||
Lincoln Dialysis Center, # 2177 | 3401 Plantation Drive, Suite # 140 | Lincoln | NE | 68516 | 769JWMN00 | 1189554 | ||||||
Dvita Mccook Dialysis Center | 801 West C Street | Mccook | NE | 69001 | 71QQ57000 | 316642 | ||||||
Davita 2540 Omaha West | 13014 West Dodge Road | Omaha | NE | 68154 | EWKVBJJ00 | 232335 | ||||||
Davita 3524 Omaha Central | 144 S. 40th St. | Omaha | NE | 68131 | B88KGYP00 | 282130 | ||||||
Davita 3533 Omaha North | 6572 Ames Ave | Omaha | NE | 68104 | G96MB4W00 | 282129 | ||||||
Davita 3534 Omaha South | 3427 L. St. Ste 16 | Omaha | NE | 68107 | J1W49YR00 | 277245 | ||||||
Davita 3550-7 Dialysis Veterans Medical Center-Acute | 4101 Woolworth Ave Floor 5th5e600 | Omaha | NE | 68105 | 2D5DF7J00 | 1463683 | ||||||
Davita-Omaha West At Home | 13014 Wet Dodge Rd | Omaha | NE | 68154 | 9BJPEW200 | 1282817 | ||||||
Davita # 3597 Papillion | 1502 South Washington | Papillion | NE | 68046 | 04LC80900 | 344584 | ||||||
Scottsbluff Dialysis Center | 3812 Avenue B. | Scottsbluff | NE | 69361 | 6VENZ7800 | 108669 | ||||||
Davita Derry Dialysis Center # 4487 | 1 Action Blvd Unit 2 | Londonderry | NH | 3053 | 6DHC1CP00 | 1616740 | ||||||
Davita 3577 Nashua | 38 Tyler St. Ste 100 | Nashua | NH | 3060 | B2AHMC200 | 316196 | ||||||
Total Renal Care - Bridgewater Dialysis Center | 2121 Us Highway 22 | Bound Brook | NJ | 8805 | F2PP1JF00 | 230899 | ||||||
Bricktown Dialysis | 525 Jack Martin Boulevard, Suite 200 | Brick | NJ | 8724 | EERA1HB00 | 281772 | ||||||
Davita 4025 Burlington North | 1164 Route 130 North | Burlington | NJ | 8016 | 0BT81DQ00 | 278180 | ||||||
Davita 3052 Cherry Hill | 1030 Kings Hwy N. Ste 100 | Cherry Hill | NJ | 8034 | UM1R4ZB00 | 225294 | ||||||
Davita 3010 Delran | 8008 Route 130 North | Delran | NJ | 8075 | 8DC99R600 | 229830 | ||||||
Davita 3231 East Orange | 90 Washington St. | East Orange | NJ | 7017 | 20LKVKM00 | 230615 | ||||||
Davita Atlantic Artificial Kidney Center | 6 Industrial Way W. Ste B. | Eatontown | NJ | 7724 | 4KHFT7K00 | 235302 | ||||||
Davita 3451 Edison | 29 Meridian Rd | Edison | NJ | 8820 | G44GE1J00 | 307713 | ||||||
Davita Hackettstown | 657 Willow Grove Street, Suite 202,,West Wing Medical Bldg. | Hackettstown | NJ | 7840 | 382KPBX00 | 1252569 | ||||||
Davita 2707 Holmdel | 668 North Beers Street | Holmdel | NJ | 7733 | K0AOQIQ00 | 208965 | ||||||
Davita 4209 Burlington County | 668 Main Street, Suite 2 | Lumberton | NJ | 8048 | LAH3JXV00 | 209151 | ||||||
Davita 3228 Freehold | 300 Craig Rd | Manalapan | NJ | 7726 | 694T80K00 | 229416 | ||||||
Davita 3077 Summit | 1139 Spruce Dr | Mountainside | NJ | 7092 | TTDVK6K00 | 230666 | ||||||
Da Vita Neptune Dialysis | 2180 Bradley Avenue | Neptune | NJ | 7753 | 690G2FC00 | 320624 | ||||||
Davita 3229 Neptune | 3297 State Route 66 Ste G1 | Neptune | NJ | 7753 | 0BMR8FB00 | 229417 | ||||||
Davita Dialysis | 571 Central Ave | Newark | NJ | 7107 | 80BAHV500 | 345923 | ||||||
Davita #3327 | 3 Hospital Plz Ste 101 | Old Bridge | NJ | 8857 | 78WBL3A00 | 275262 | ||||||
Davita 5988 Pennsauken At Home Dialysis | 7024 Kaighns Ave | Pennsauken | NJ | 8109 | 04AWTQT00 | 1454081 | ||||||
Davita Pennsauken Dialysis Center | 7024 Kaighns Ave | Pennsauken | NJ | 8109 | 179TDPC00 | 1449210 | ||||||
Davita 3326 Perth Amboy | 530 New Brunswick Ave | Perth Amboy | NJ | 8861 | 563EV9W00 | 275263 | ||||||
Davita 3493 Plainfield | 1200 Randolph Rd | Plainfield | NJ | 7060 | AJ55FBT00 | 285210 | ||||||
Davita Plainfield At Home # 6042 | 1200 Randolph Road | Plainfield | NJ | 7060 | FG1F29M00 | 1199851 | ||||||
Middletown Dialysis Center - #529 | 500 Highway 35 South, Union Square, Suite 9a | Red Bank | NJ | 7701 | 5HNWT3100 | 346095 | ||||||
Davita Somerset Dialysis Center #414 | 240 Chruchill Avenue | Somerset | NJ | 8873 | 5AG0K2H00 | 347359 | ||||||
Davita 3556 Willingboro | 230 Van Sciver Pkwy | Willingboro | NJ | 8046 | 52W9Y7H00 | 1161496 | ||||||
Davita Willingboro At Home Dialysis | 230 Van Sciver Pkwy | Willingboro | NJ | 8046 | A3JG6TB00 | 1608919 | ||||||
Davita - Artesia Dialysis Center # 4348 | 702 N. 13th St. | Artesia | NM | 88210 | 2DF8E2V00,2DF8R2V00 | 1468108 | ||||||
Davita Artesia At Home Dialysis | 702 N. 13th St. | Artesia | NM | 88210 | D5YDJEQ00 | 1468187 | ||||||
Davita - Four Corners Dialysis Center | 801 West Broadway | Farmington | NM | 87401 | B724C0000 | 210054 | ||||||
Davita Shiprock Dialysis Center | Us Highway 666 North, PO Box 2156 | Shiprock | NM | 87420 | 1BVHF4700 | 231283 | ||||||
Davita Carson City Dialysis Center #1979 | 3310 Goni Rd Bldg H Ste 171 | Carson City | NV | 89706 | 340AA0R00 | 1474586 | ||||||
Davita Fallon Dialysis #2224 | 1103 New River Parkway | Fallon | NV | 89406 | 7DRCP9L00 | 1279365 | ||||||
Davita | 2530 Anthem Village Dr | Henderson | NV | 89052 | JEH0PJM00 | 1077145 | ||||||
Davita 2271 Green Valley Dialysis Center | 1510 W. Warm Springs Rd Suite 100 | Henderson | NV | 89014 | 11QGT9A00 | 1453993 | ||||||
Davita Siena Henderson #2197 | 2865 Siena Heights Drive, Suite 141 | Henderson | NV | 89052 | J0VA6RL00 | 1233181 | ||||||
Davita | 2881 Business Park Ct Ste 130 | Las Vegas | NV | 89128 | 3JC7CVC00 | 276826 | ||||||
Davita - Las Vegas Dialysis Center | 3100 West Charleston, Suite 100 | Las Vegas | NV | 89102 | SZ1MU9H00 | 210097 | ||||||
Davita - Summerlin Dialysis Center | 653 Town Center Drive, Building 2, Suite 70 | Las Vegas | NV | 89144 | FLGXMDC00 | 285249 | ||||||
Davita 2367 Centennial Dialysis Center | 8775 Deer Springs Way | Las Vegas | NV | 89149 | 5KFR5TT00 | 1418942 | ||||||
Davita 2496 Fivestar Dialysis Center | 2400 Tech Center Ct | Las Vegas | NV | 89128 | A6JC45K00 | 1453990 | ||||||
Davita Desert Springs | 2110 East Flaming Road, Suite 108 | Las Vegas | NV | 89119 | AK9Y82B00 | 1223989 | ||||||
Davita Five Star @Home #5980 | 2400 Tech Center Ct | Las Vegas | NV | 89128 | GKR4YLE00 | 1621289 | ||||||
Davita Las Vegas At Home | 3100 West Charleston, Suite 100 | Las Vegas | NV | 89102 | 49765D800 | 1263882 | ||||||
Davita Las Vegas Pediatric Dialysis | 7271 W. Sahara Ave Suite 120 | Las Vegas | NV | 89117 | 5KV6XTG00 | 1453825 | ||||||
Davita Southern Hills Dialysis Center #2048 | 9280 West Sunset Road, Suite 110 | Las Vegas | NV | 89148 | 3CF5DJV00 | 1095936 | ||||||
South Las Vegas Dialysis Center - Davita | 2250 South Rancho, Suite 115 | Las Vegas | NV | 89102 | 0D2YHB500 | 281412 | ||||||
Davita - North Las Vegas | 2300 Mcdaniel Street | North Las Vegas | NV | 89030 | CAS2LUV00 | 223774 | ||||||
Davita Pahrump Dialysis #547 | 330 S. Lola Ln | Pahrump | NV | 89048 | 0B97ACD00 | 280496 | ||||||
Davita - Sierra Rose At Home | 685 Sierra Rose Drive | Reno | NV | 89511 | H2F0EEQ00 | 1401195 | ||||||
Davita Reno At Home Dialysis #5961 | 1500 E. 2nd St. Ste 106 | Reno | NV | 89502 | 91K2R4R00 | 1488254 | ||||||
Davita Reno Dialysis Center #1978 | 1500 E. 2nd St. Ste 101 | Reno | NV | 89502 | 9CPTYQR00 | 317874 | ||||||
Davita South Meadows Dialysis Center #1977 | 10085 Double R. Blvd Ste 160 | Reno | NV | 89521 | 139NQD300 | 1266181 | ||||||
Sierra Rose Dialysis Center | 685 Sierra Rose Drive | Reno | NV | 89511 | 3AEA13500 | 345697 | ||||||
Davita - Sparks Dialysis | 4860 Vista Boulevard, Suite 100 | Sparks | NV | 89436 | GL5F5LB00 | 229111 | ||||||
Boston Post Road Dialysis Center | 4026 Boston Road | Bronx | NY | 10475 | 0GVMMRA00 | 275579 | ||||||
Davita #0501 Bronx Dialysis Center | 1615 East Chester Rd | Bronx | NY | 10461 | 3HJHHGH00 | 232606 | ||||||
Davita - Eastchester Road Dialysis | 1515 Jarrett Place | Bronx | NY | 10461 | 3JQGGNV00 | 1264457 | ||||||
Davita Bedford Park Dialysis #2355 | 3119 Webster Ave Frnt 1 | Bronx | NY | 10467 | 7BGD27K00 | 1436099 | ||||||
Davita Bronx At Home | 1615 Eastchester Road | Bronx | NY | 10461 | G61TB4V00 | 1272770 | ||||||
Riverdale Dialysis | 170 W. 233rd St. | Bronx | NY | 10463 | C7TY8WE00 | 232195 | ||||||
Soundview Dialysis Center | 1622-24 Bruckner Boulevard | Bronx | NY | 10473 | B1X8PNT00 | 277273 |
Page 43 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
South Bronx Kidney Center | 1940 Webster Avenue | Bronx | NY | 10457 | 0PLOHU900 | 209970 | ||||||
Davita - Sheepshead Bay Renal Care Dialysis Center #536 | 26 Brighton 11 St. | Brooklyn | NY | 11235 | A20RBQ400 | 277271 | ||||||
Dyker Heights Dialysis Center | 1435 86th Street | Brooklyn | NY | 11228 | 93MBLWQ00 | 277619 | ||||||
South Brooklyn Nephrology Center, Inc. | 3915 Avenue V. | Brooklyn | NY | 11234 | FGSYYJ200 | 209962 | ||||||
Utica Avenue Dialysis Clinic | 1305 Utica Ave | Brooklyn | NY | 11203 | 9P5B65P00 | 230194 | ||||||
Renal Care of Buffalo, Inc. | 550 Orchard Park Road, Suite B104 | Buffalo | NY | 14224 | LJ553XE00 | 221765 | ||||||
Total Renal Care, Dba: Cleve Hill Dialysis Center | 1461 Kensington Avenue | Buffalo | NY | 14215 | 61V71T300 | 276702 | ||||||
Davita Celia Dill Dialysis Center #520 | 667 Stoneleigh Avenue, Suite 123 | Carmel | NY | 10512 | ELXCFF200 | 278156 | ||||||
Peekskill - Cortlandt Dialysis Center | 2050 East Main Street | Cortlandt Manor | NY | 10567 | DHGK7AB00 | 275316 | ||||||
Davita #3264 Freeport Kidney Center | 267 W. Merrick Rd | Freeport | NY | 11520 | ASIEOE000 | 209949 | ||||||
Garden City Dialysis | 1100 Stewart Ave Ste 2 | Garden City | NY | 11530 | HL8TQF800 | 278794 | ||||||
Davita Huntington Station Kc At Home | 256 Broadway | Huntington Station | NY | 11746 | JGR9W8300 | 1275456 | ||||||
Huntington Artificial Kidney Center | 256 Broadway | Huntington Station | NY | 11746 | XV4ZZF900 | 209965 | ||||||
Ithaca Dialysis Clinic | 201 Dates Dr Ste 206 | Ithaca | NY | 14850 | 5BTRRQH00 | 213380 | ||||||
Queens Dialysis Center | 118-01 Guy Brewer Boulevard | Jamaica | NY | 11434 | 6D95A6D00 | 275609 | ||||||
Lynbrook Dialysis Center | 147 Scranton Avenue | Lynbrook | NY | 11563 | AJCATX500 | 277275 | ||||||
Davita #3266 Medford | 1725 North Ocean Avenue | Medford | NY | 11763 | JTKF0FQ00 | 227798 | ||||||
Catskill Dialysis | 139 Forestburgh Rd | Monticello | NY | 12701 | JFXHY6G00 | 221169 | ||||||
Catskill Dialysis Center | 139 Forestburgh Road | Monticello | NY | 12701 | K1BJ9L900 | 1108326 | ||||||
Davita Columbia University At Home Dialysis | 60 Haven Ave | New York | NY | 10032 | 31AKJVC00 | 1449300 | ||||||
Davita Columbia University Dialysis Center | 60 Haven Avenue, Suite B3 and B4 | New York | NY | 10032 | J2M7TV200 | 316217 | ||||||
Port Chester Dialysis Unit | 38 Bulkley Ave | Port Chester | NY | 10573 | 2TKXPGH00 | 230633 | ||||||
Port Washington Dialysis | 50 Seaview Boulevard | Port Washington | NY | 11050 | L6E8H3X00 | 277274 | ||||||
Queens Village Dialysis | 222-02 Hempstead Avenue | Queens Village | NY | 11429 | 95WJLXB00,KDQVK1300 | 281411 | ||||||
Davita Richmond Kidney Center | 1366 Victory Blvd | Staten Island | NY | 10301 | 10MHL8X00 | 209953 | ||||||
Davita #3263 Syosset Kidney Center | 1 Locust Ln | Syosset | NY | 11791 | KWYJVD500 | 227796 | ||||||
Hudson Valley Dialysis Center, Inc. | 155 White Plains Road, Suite 107 | Tarrytown | NY | 10591 | 71DY61Q00 | 235634 | ||||||
Davita-Renal Care of Buffalo #6203 | 550 Orchard Park Rd Ste B102 | West Seneca | NY | 14224 | DLYBTAA00 | 1282631 | ||||||
White Plains Dialysis Center | 200 Hamilton Avenue, Space 13b | Whiteplains | NY | 10601 | KA2ALLC00 | 280825 | ||||||
Davita East Yonkers Dialysis Center #2394 | 5 Odell Plz Ste 131 | Yonkers | NY | 10701 | J8CP6HF00 | 1473017 | ||||||
Yonkers Dialysis Center | 575 Yonkers Avenue | Yonkers | NY | 10704 | L7QTVFL00 | 277272 | ||||||
Davita- Alliance Dialysis # 1790 | 270 E. State St. Ste 110 | Alliance | OH | 44601 | 19BQ3KY00,67XG7HE00 | 1125721 | ||||||
Davita Ohio Pike Dialysis Center # 4380 | 1761 State Route 125 | Amelia | OH | 45102 | D1PVMEY00 | 1463991 | ||||||
Davita Andover Dialysis | 488 South Main Street | Andover | OH | 44003 | 79A6K9P00 | 1224061 | ||||||
Davita 3511 Ashtabula | 1614 West 19th Street | Ashtabula | OH | 44004 | 9VWATVY00 | 209867 | ||||||
Davita 4416 Rivers Edge Dialysis | 1006 E. State St. Suite B. | Athens | OH | 45701 | 8JXV4YL00 | 1478838 | ||||||
Davita #2316 Batavia Dialysis | 4000 Golden Age Dr | Batavia | OH | 45103 | 7BQJBHJ00 | 1422788 | ||||||
Davita - Belpre At Home | 2906 Washington Boulevard | Belpre | OH | 45714 | 35QV66500 | 1220463 | ||||||
Davita 3663 Belpre | 2906 Washington Blvd | Belpre | OH | 45714 | D9RY7FX00 | 1100252 | ||||||
Davita 3344 Guernsey County | 1300 Clark Street | Cambridge | OH | 43725 | 68TGPX900 | 228856 | ||||||
Davita - Belden Dialysis # 1791 | 4685 Fulton Dr Nw | Canton | OH | 44718 | BGHY3NW00 | 275949 | ||||||
Davita - Mercy Dialysis #1792 | 1320 Mercy Drive Northwest, Mercy Hall | Canton | OH | 44708 | 82KFAEX00 | 319839 | ||||||
Davita 0940 Eastgate Dialysis | 4435 Aicholtz, Suite 800a | Cincinnati | OH | 45245 | 68683KF00 | 1400593 | ||||||
Davita 3267 Blue Ash Southwest Ohio Jv | 10600 McKinley Road | Cincinnati | OH | 45242 | 13B3K9B00,TT9WN9N00 | 213545 | ||||||
Davita 3340 Western Hills | 3267 Westbourne Dr | Cincinnati | OH | 45248 | 54V7XBJ00 | 284508 | ||||||
Davita 3341 Winton Road Southwest Ohio | 6550 Winton Rd | Cincinnati | OH | 45224 | LK1WN6V00 | 276651 | ||||||
Davita 3443 Silverton | 6929 Silverton Ave | Cincinnati | OH | 45236 | 73KLG3Y00 | 286069 | ||||||
Davita Dearborn Acutes Dialysis | 10600 McKinley Rd | Cincinnati | OH | 45242 | 6DK4JXN00 | 1418627 | ||||||
Davita East Galbraith Dialysis Center # 2317 | 3877 E. Galbraith Rd | Cincinnati | OH | 45236 | 0GMN24V00 | 1468266 | ||||||
Davita Eastgate Home Training #2340 | 4435 Aicholtz Road,Suite 800b | Cincinnati | OH | 45245 | 0LTR32A00 | 1270151 | ||||||
Davita Forest Fair Dialysis Center | 1145 Kemper Meadow Dr | Cincinnati | OH | 45240 | KC4GT7G00 | 1454019 | ||||||
Davita Mount Auburn Dialysis Center #3269 | 2109 Reading Road | Cincinnati | OH | 45202 | 5D61C9A00 | 209872 | ||||||
Davita Mt. Auburn Southwest Ohio Jv | 2109 Reading Rd | Cincinnati | OH | 45202 | 5D61C9AF0 | 1249867 | ||||||
Davita Norwood Dialysis Center # 4426 | 2300 Wall St. | Cincinnati | OH | 45212 | 49M1W1X00 | 1483934 | ||||||
Davita Red Bank Dialysis Center #4427 | 3960 Red Bank Rd | Cincinnati | OH | 45227 | 1C8MHAY00 | 1475097 | ||||||
Davita White Oak At Home #6050 | 5520 Cheviot Road, Suite B. | Cincinnati | OH | 45247 | JC1D3BN00 | 1216207 | ||||||
Davita White Oak Dialysis | 5520 Cheviot Road, Suite B. | Cincinnati | OH | 45247 | L7TCEX800 | 1219148 | ||||||
Davita White Oak Pd | 5520 Cheviot Road, Suite B. | Cincinnati | OH | 45247 | 9BR1WPX00 | 1256104 | ||||||
Davita- Delhi Dialysis Center | 5040 Delhi Pike | Cincinnati | OH | 45238 | LLLBQRJ00 | 1282981 | ||||||
Davita-Anderson #2293 | 7502 State Rd Ste 1160 Bldg 2 | Cincinnati | OH | 45255 | 9CWLMAY00 | 1282889 | ||||||
Davita # 1862 Shaker Square | 12800 Shaker Blvd Ste 1 | Cleveland | OH | 44120 | AFD1GAT00,L7QNQA500 | 232668 | ||||||
Davita #5522 Detroit Dialysis | 7901 Detroit Avenue | Cleveland | OH | 44102 | 16K1P9Q00 | 323950 | ||||||
Davita Middleburg Heights Dialysis Center #1620 | 7360 Engle Rd | Cleveland | OH | 44130 | 7KTN50C00,H21EAJR00 | 234908 | ||||||
Davita Parma Dialysis Center | 6735 Ames Rd | Cleveland | OH | 44129 | 026232F00 | 281257 | ||||||
Davita Quadrangle Dialysis #5523 | 2302 Community College Ave | Cleveland | OH | 44115 | 2KENDRR00 | 1644350 | ||||||
Davita - Columbus East At Home | 299 Outerbelt Street | Columbus | OH | 43213 | 6GAH7EY00 | 1259637 | ||||||
Davita - Columbus West Dialysis Center | 1395 Georgesville | Columbus | OH | 43228 | 3BJRN9K00,JJR1T6T00 | 1289317 | ||||||
Davita 3354 Columbus | 3830 Olentangy River Rd | Columbus | OH | 43214 | JDEBHAC00 | 229658 | ||||||
Davita 3454 Columbus East | 299 Outerbelt St. | Columbus | OH | 43213 | 811M3QP00 | 284437 | ||||||
Davita 3566 Columbus Downtown | 415 East Mound Street | Columbus | OH | 43215 | 5ADJM6300 | 319940 | ||||||
Davita 6220 Columbus West At Home | 1391 Georgesville Rd | Columbus | OH | 43228 | A50FPRA00 | 1454080 | ||||||
Davita 3612 Coshocton | 1404 Chestnut St. | Coshocton | OH | 43812 | D6WXNWV00 | 346615 | ||||||
Davita Dover Dialysis #5008 | 899 E. Iron Ave | Dover | OH | 44622 | 7BHNWEW00 | 1662259 | ||||||
Davita 2419 Dublin Dialysis Center | 6770 Perimeter Loop Rd | Dublin | OH | 43016 | 5KFV4QT00 | 1422705 | ||||||
Davita-Eaton Dialysis | 105 East Washington Jackson Road | Eaton | OH | 45320 | 35H8YWR00 | 1279770 | ||||||
Davita Lorain County Home Dialysis | 824 E. Broad St. | Elyria | OH | 44035 | H3WED9G00 | 1588586 | ||||||
Davita Fairborn At Home #5937 | 1266 N. Broad St. | Fairborn | OH | 45324 | 541JRXH00 | 1683010 | ||||||
Davita Fairborn Dialysis Center #2162 | 3070 Presidential Drive, Suite 100 | Fairborn | OH | 45324 | 1CBKVHK00 | 1172822 | ||||||
Davita Midwest Fairborn Dialysis #5571 | 1266 N. Broad St. | Fairborn | OH | 45324 | 9F8CMLF00 | 317819 | ||||||
Davita #3290 Fairfield Home Pd | 1210 Hicks Boulevard | Fairfield | OH | 45014 | EF0YVAW00 | 1228967 | ||||||
Davita - Fairfield | 1210 Hicks Boulevard | Fairfield | OH | 45014 | C3DG15E00 | 276537 | ||||||
Davita Fairview Dialysis Center #4350 | 19050 Lorain Rd | Fairview Park | OH | 44126 | HKPPRKQ00 | 1617078 | ||||||
Davita Great Northern Dialysis Center # 4354 | 22710 Fairview Center Dr Ste 100 | Fairview Park | OH | 44126 | K0P0WRW00 | 1496685 | ||||||
Davita Butler County | 3497 South Dixie Highway | Franklin | OH | 45005 | 7AEFXJQ00 | 318570 | ||||||
Davita Butler County Home Training | 3497 South Dixie Highway | Franklin | OH | 45005 | 8F214C600 | 1233077 | ||||||
Davita 2408 Us Grant Dialysis Center | 458 Home St. | Georgetown | OH | 45121 | 335MLGY00 | 1454175 | ||||||
Davita - Grove City Dialysis #2319 | 4155 Kelnor Drive | Grove City | OH | 43123 | 9LC069L00 | 1285545 | ||||||
Davita Highland County Dialysis Center #4471 | 120 Roberts Ln | Hillsboro | OH | 45133 | 58NM1XK00 | 1616719 | ||||||
Davita Rockside At Home #5931 | 4801 Acorn Dr | Independence | OH | 44131 | J6A556F00 | 1694845 | ||||||
Davita Rockside Dialysis | 4801 Acorn Dr | Independence | OH | 44131 | 72B51MC00 | 1453965 | ||||||
Davita Kettering At Home #6118 | 5721 Bigger Road | Kettering | OH | 45440 | KALLMRD00 | 1275515 | ||||||
Davita Kettering Dialysis | 5721 Bigger Road | Kettering | OH | 45440 | 9JYA7JQ00 | 1246511 | ||||||
Davita-Lebanon Home Training | 918 Columbus Ave # B. Ste 2 | Lebanon | OH | 45036 | 5CMF3TE00,J7VV50L00 | 1285371 | ||||||
Davita Logan Dialysis Center #2433 | 12880 Grey St. | Logan | OH | 43138 | 8FNN7NR00 | 1453917 | ||||||
Davita Amherst Dialysis Center #2255 | 3200 Cooper Foster Park Rd W. | Lorain | OH | 44053 | B6FQJ6B00 | 1699283 | ||||||
Davita 5986-1 Belden Community At Home Dialysis | 7770 Columbus Rd | Louisville | OH | 44641 | 64WA3VE00 | 1463827 | ||||||
Davita 3334 Lake County | 1963 Hubbard Rd | Madison | OH | 44057 | B6J9LA400 | 276534 | ||||||
Davita 3345 Marietta | 1019 Pike St. | Marietta | OH | 45750 | FG2QM4D00 | 232926 | ||||||
Davita Clermont Dialysis Center 4438 | 5901 Montclair Blvd Ste 100 | Milford | OH | 45150 | 29MNLGL00 | 1608972 | ||||||
Davita 2481 Cherry Valley Dialysis | 1627 W. Main St. | Newark | OH | 43055 | 0GM0P0R00 | 1478836 | ||||||
Davita 3347 Licking County | 65 Mcmillen Dr Ste 300 | Newark | OH | 43055 | LPFPK7500 | 232241 | ||||||
Davita North Rivdgeville Dialysis Center #4351 | 35143 Center Ridge Rd | North Ridgeville | OH | 44039 | 1FWTJMA00 | 1647710 | ||||||
Davita 3677 Toledo East | 611 Lemoyne Rd | Northwood | OH | 43619 | K1VTX2800 | 1172658 | ||||||
Davita Dialysis - Parma Community General Hospital #1619-1-Acute | 7007 Powers Blvd | Parma | OH | 44129 | 7C34J2B00 | 1479411 | ||||||
Davita - Pataskala | 642 East Broad Street | Pataskala | OH | 43062 | 6LB56R400 | 1275879 | ||||||
Davita - Rocky River Dialysis Center #1621 | 20220 Center Ridge Rd Ste 50 | Rocky River | OH | 44116 | E7D0W8200 | 278559 | ||||||
Davita 2283 Sandusky Dialysis | 795 Bardshar Road | Sandusky | OH | 44870 | K8997YF00 | 1263963 | ||||||
Davita Silverton Dialysis | 6929 Silverton Avenue | Silverton | OH | 45236 | 73KLG3YF0 | 346978 | ||||||
Davita Midwest Springfield Dialysis #5570 | 2200 N. Limestone St. Ste 104 | Springfield | OH | 45503 | 97QG9WR00 | 261068 | ||||||
Davita Dialysis 3676-4 Acuity Specialty Hospital-Acute | 380 Summit Ave | Steubenville | OH | 43952 | JBR5AJJ00 | 1463573 | ||||||
Davita-Strongsville At Home | 17792 Pearl Rd. | Strongsville | OH | 44136 | E8KF7E600 | 1283066 |
Page 44 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita | 17792 Pearl Road | Strongville | OH | 44136 | KKE5HAE00 | 1189549 | ||||||
Seneca County Dialysis | 65 St. Francis Street, Betty Jane Center | Tiffin | OH | 44883 | AEB98Q600 | 281016 | ||||||
Davita 3520 Toledo | 1614 South Byrne Road, Suite R. | Toledo | OH | 43614 | 7AL1T6200 | 235907 | ||||||
Davita Point Place Dialysis Center #2306 | 4747 Sudar Avenue, Suite 107 | Toledo | OH | 43611 | BELHC3600 | 1279404 | ||||||
Davita Toledo At Home | 1614 S. Byrne | Toledo | OH | 43614 | B94Y7G900 | 1279348 | ||||||
Davita 2435 Urbana Dialysis | 1880 E. Us Highway 36 | Urbana | OH | 43078 | 718W37M00 | 1432811 | ||||||
Davita Midwest Urbana Dialysis # 5572 | 1430 Us Hwy 36 E. Ste A | Urbana | OH | 43078 | 87CN44M00 | 1448433 | ||||||
Davita #2334 Wadsworth | 195 Wadsworth Rd Ste 302 | Wadsworth | OH | 44281 | A45390V00 | 1449380 | ||||||
Davita Wadsworth At Home #5932 | 195 Wadsworth Rd | Wadsworth | OH | 44281 | FG1LCXQ00 | 1694844 | ||||||
Davita - Wauseon Dialysis #2254 | 721 South Shoop Avenue | Wauseon | OH | 43567 | CAR5ATL00 | 1285370 | ||||||
Davita #5524 West Shore Dialysis | 29000 Center Ridge Road | Westlake | OH | 44145 | CDC3Q3X00 | 312057 | ||||||
Davita Willow Dialysis Center #1740 | 1675 Alex Dr | Wilmington | OH | 45177 | 7KN9TYE00 | 229805 | ||||||
Southwest Ohio Dialysis #1541 | 215 South Allison Avenue | Xenia | OH | 45385 | 70293RC00 | 274986 | ||||||
Davita 3346 Zanesville | 3120 Newark Rd | Zanesville | OH | 43701 | F2TGBOP00 | 209863 | ||||||
Davita Zanesville At Home | 3120 Newark Road | Zanesville | OH | 43701 | E22RHWM00 | 1220454 | ||||||
Davita - Altus Dialysis Center | 205 South Park Lane, Suite 130 | Altus | OK | 73521 | J2RKXB400 | 223140 | ||||||
Davita Anadarko Dialysis Center | 412 Southeast 11th Street | Anadarko | OK | 73005 | 7C5J54G00 | 276642 | ||||||
Davita - Northwest Bethany | 7800 Nw 23rd St. Ste A | Bethany | OK | 73008 | WE6FE3C00 | 213742 | ||||||
Davita Northwest Bethany At Home | 7800 Nw 23rd Street, Suite A | Bethany | OK | 73008 | A80BAX000 | 1272771 | ||||||
Da Vita - Broken Arrow Dialysis Center | 601 South Aspen Avenue | Broken Arrow | OK | 74012 | 774TZHR00 | 227277 | ||||||
Davita Chickasha Dialysis Center #2080 | 228 South 29th | Chickasha | OK | 73018 | KE0LB8200 | 1189187 | ||||||
Da Vita - Claremore Dialysis Center | 202 East Blue Starr Drive | Claremore | OK | 74017 | 4G7S4M900 | 227267 | ||||||
Davita Clinton Dialysis Center | 150 South 31st Street | Clinton | OK | 73601 | 3B8APN800 | 320622 | ||||||
Davita - Duncan Dialysis | 2645 West Elk | Duncan | OK | 73533 | XRNDCRR00 | 221981 | ||||||
Davita - Durant #2024 | 411 Westside Drive | Durant | OK | 74701 | CKVF7W900 | 1077268 | ||||||
Davita - Edmond Dialysis | 50 South Baumann Avenue | Edmond | OK | 73034 | FEMAYQD00 | 235746 | ||||||
Davita - Elk City | 1601 West 2nd Street | Elk City | OK | 73644 | 2H05B3200 | 231099 | ||||||
Davita Lexington #3314 | Lexington Assessment and Reception Center, Highway 39 East | Lexington | OK | 73051 | 99EXW6V00 | 275956 | ||||||
Davita Tri-State Dialysis Center #975 | 2510 North Main Street | Miami | OK | 74354 | 88MPQR800 | 280491 | ||||||
Davita Midwest City Dialysis Center #955 | 7221 East Reno Avenue | Midwest City | OK | 73110 | 21KWTFR00 | 213410 | ||||||
Davita - Muskogee Community Dialysis #974 | 2316 W. Shawnee St. | Muskogee | OK | 74401 | A1P0J8R00 | 280492 | ||||||
Davita - Norman | 1818 West Lindsey, B. 104 | Norman | OK | 73069 | 7EM14KW00 | 227112 | ||||||
Davita 3015 Oklahoma City South | 5730 S. May Ave | Oklahoma City | OK | 73119 | 641C49000 | 225127 | ||||||
Davita 3201 Heartland | 925 Ne 8th St. | Oklahoma City | OK | 73104 | 2F27HV200,F6M6HQK00 | 230975 | ||||||
Davita Cinema Dialysis | 3909 South Western | Oklahoma City | OK | 73109 | 658LQE800 | 1138007 | ||||||
Davita Heartland At Home Clinic #6276 | 925 Ne 8th Street | Oklahoma City | OK | 73104 | C5JEEXP00 | 1272832 | ||||||
Davita #972 - Okmulgee Dialysis Center | 201 S. Delaware Ave | Okmulgee | OK | 74447 | 6K5L6TF00 | 280489 | ||||||
Davita Pryor Dialysis Center #3014-1 | 309 E. Graham Ave | Pryor | OK | 74361 | F23QYCK00 | 229055 | ||||||
Davita - Shawnee Dialysis Center | 4409 N. Kickapoo Ave, Ste 113 | Shawnee | OK | 74804 | 1GJD22H00 | 213451 | ||||||
Davita - Stillwater Dialysis Center | 406 East Hall of Fame Avenue, Suite 300 | Stillwater | OK | 74075 | 18L1MQ700 | 225731 | ||||||
Davita - Stilwell Dialysis Center | 319 N. 2nd St. | Stilwell | OK | 74960 | DETGHTA00 | 280495 | ||||||
Da Vita - Tahlequah Dialysis Center | 228 North Bliss Avenue | Tahlequah | OK | 74464 | CSSFN5300 | 227272 | ||||||
Davita - Central Tulsa Dialysis | 1124 South St. Louis Avenue | Tulsa | OK | 74120 | 2CQDDHB00 | 280490 | ||||||
Davita - Tulsa | 4436 S. Harvard Ave | Tulsa | OK | 74135 | RTSIATX00 | 227279 | ||||||
Davita Greenwood Dialysis Center #2037 | 1345 North Lansing Avenue | Tulsa | OK | 74106 | 00L4W2N00 | 1141782 | ||||||
Davita Sapulpa Dialysis Center | 9647 Ridgeview St. | Tulsa | OK | 74131 | 3D54YTG00 | 319589 | ||||||
Davita Southcrest | 9001 S. 101 East Ave Ste 110 | Tulsa | OK | 74133 | EJ1TAAB00 | 1125460 | ||||||
Davita-Tulsa At Home | 4436 S. Harvard Ave | Tulsa | OK | 74135 | GEJ0LLJ00 | 1283098 | ||||||
Davita 2096 Ashland Dialysis Center | 1661 Highway 99 N. Bldg A | Ashland | OR | 97520 | 136NELW00 | 1463638 | ||||||
Davita # 5517 Redwood Dialysis | 201 Southwest L. Street | Grants Pass | OR | 97526 | XKLNTR900 | 228709 | ||||||
Davita 2238 Grants Pass | 1055 Redwood Avenue | Grants Pass | OR | 97527 | 5KKDNPY00 | 1263962 | ||||||
Davita - Hermiston Dialysis Center | 1155 West Linda Avenue | Hermoston | OR | 97838 | FJ62DN600 | 319932 | ||||||
Davita Hillsboro Dialysis Center #2168 | 2500 Northwest 229th Avenue, Suite 300 | Hillsboro | OR | 97124 | G6TNTRM00 | 1216148 | ||||||
Davita Klamath Falls Dialysis # 1967 | 2230 N. Eldorado Ave | Klamath Falls | OR | 97601 | 24VMQKX00 | 1483698 | ||||||
Davita Mcminnville Dialysis #5045 | 200 Ne Norton Ln | Mcminnville | OR | 97128 | 30PMX3E00 | 1727543 | ||||||
Davita-Willamette Valley Medical Center # 1084-1-Acute | 2700 Se Stratus Ave | Mcminnville | OR | 97128 | AFF9AAX00 | 1473309 | ||||||
Davita #5516 Rogue Valley Dialysis | 760 Golf View Dr Unit 100 | Medford | OR | 97504 | F6LXRTN00 | 209047 | ||||||
Davita Rouge Valley At Home #5952 | 760 Golf View Dr Unit 100 | Medford | OR | 97504 | H61ND8W00 | 1620851 | ||||||
Davita Dialysis Ontario Pd | 515 East Lane | Ontario | OR | 97914 | BAYGQD200 | 1212214 | ||||||
Davita Four Rivers At Home | 515 East Lane | Ontario | OR | 97914 | 2F06Q3G00 | 1270070 | ||||||
Davita Four Rivers Dialysis Center #1818 | 515 East Lane | Ontario | OR | 97914 | KB2G9N900 | 231096 | ||||||
Davita - Blue Mountain Dialysis | 72556 Coyote Road | Pendelton | OR | 97801 | 53H34NJ00 | 1401455 | ||||||
Davita Dialysis 3804 Roseburg-Mercy | 2599 Nw Edenbower Blvd | Roseburg | OR | 97471 | D3R4VHN00 | 228700 | ||||||
Davita Rosenburg Mercy At Home # 6320 Dialysis | 2599 Nw Edenbower Blvd | Roseburg | OR | 97471 | 950KTLC00 | 1473176 | ||||||
Davita 3858 Salem-North | 1220 Liberty St. Ne* | Salem | OR | 97301 | J9QT3FT00 | 278159 | ||||||
Davita Salem Dialysis | 3550 Liberty Rd S. | Salem | OR | 97302 | 32CFWRJ00 | 209822 | ||||||
Davita Sherwood Dialysis Center | 21035 Sw Pacific Hwy | Sherwood | OR | 97140 | 43YFQR100 | 1126124 | ||||||
Davita Meridian Park At Home | 19255 Southwest 65th Avenue, Suite 100 | Tualatin | OR | 97062 | 30WVP8R00 | 1229596 | ||||||
Davita Meridian Park Dialysis Center | 19255 Sw 65th Ave Ste 100 | Tualatin | OR | 97062 | ALDP3WW00 | 1215991 | ||||||
Davita West Linn | 19056 Williamette Drive | West Linn | OR | 97068 | C0A5FFL00 | 1282971 | ||||||
Davita 4044 Woodburn | 2245 Country Club Rd | Woodburn | OR | 97071 | 5MXH1V100 | 229507 | ||||||
Davita 4217 Bradford | 665 East Main Street | Bradford | PA | 16701 | 6V6MJ4G00 | 209762 | ||||||
Davita Bradford At Home | 665 East Main Street | Bradford | PA | 16701 | 66MY6BD00 | 1220467 | ||||||
Davita #0854 Camp Hill At Home | 425 North 21st Street, Plaza 21 Bldg, 1st Floor | Camp Hill | PA | 17011 | 78JETMR00 | 1401196 | ||||||
Davita #6163 Camp Hill Dialysis Center | 425 North 21st Street, Plaza 21, First Floor | Camp Hill | PA | 17011 | O4L6VYC00 | 209751 | ||||||
Davita Upland Dialysis | 1 Med Center Blvd., Suite 120 | Chester | PA | 19013 | 1275933 | |||||||
Davita Dialysis Center - Childs Unit | 101 South Main Street | Childs | PA | 18407 | D9EVD8G00 | 346877 | ||||||
Davita 3596 Clearfield | 1033 Turnpike Avenue, Suite 100 Ssj Waterwork Medical Bldg. of Clearfield | Clearfield | PA | 16830 | 37WV6JQ00 | 320700 | ||||||
Davita 4204 Corry | 300 York St. | Corry | PA | 16407 | C20YARD00 | 225681 | ||||||
Davita - Dubois Dialysis | 5780 Shaffer Road, Suite 106b | Du Bois | PA | 15801 | HDRJ9T600 | 209759 | ||||||
Davita Dunmore At Home | 1212 Oneil Highway | Dunmore | PA | 18512 | 64XNNWD00 | 1233070 | ||||||
Davita Dunmore Dialysis | 1212 O’Neil Highway | Dunmore | PA | 18512 | 01MRYQ200 | 346881 | ||||||
Davita Pocono Dialysis Center | 447 Office Plaza Drive, 100 Plaza Court, Suite B. | East Stroudsburg | PA | 18301 | 725GN8P00 | 231100 | ||||||
Palmer Dialysis Center - A Total Renal Care Facility | 30 Community Drive | Easton | PA | 18045 | 4C6FLH300 | 233712 | ||||||
Davita Dialysis - Ebensburg | 236 Jamesway Rd | Ebensburg | PA | 15931 | F2K4DGY00 | 306275 | ||||||
Davita 2510 Elizabeth | 201 McKeesport Rd | Elizabeth | PA | 15037 | C1DPAQF00 | 1100191 | ||||||
Davita Elizabeth At Home | 201 McKeesport | Elizabeth | PA | 15037 | F3LJBB800 | 1282633 | ||||||
Davita 4208 Elizabethtown | 844 North Hanover Street | Elizabethtown | PA | 17022 | EHK3HCB00 | 231246 | ||||||
Davita 3477 Elkins Park | 8380 Old York Rd Ste 100 | Elkins Park | PA | 19027 | AC8903600 | 261201 | ||||||
Davita 4027 Erie | 350 East Bayfront Parkway, Suite A | Erie | PA | 16507 | JJFJ9HQ00 | 209742 | ||||||
Davita- Erie At Home | 350 East Bayfront Parkway, Suite A | Erie | PA | 16507 | BK4R7PM00 | 1282927 | ||||||
Renal Care of Erie | 1641 Sassafras St. | Erie | PA | 16502 | F8D6THG00 | 209757 | ||||||
Davita #0857 Exton | 710 Springdale Dr | Exton | PA | 19341 | GBKN85B00 | 209763 | ||||||
Davita Frackville Dialysis #5031 | 801 Schulkill Mall Rd Ste 801 | Frackville | PA | 17931 | K3Y212Q00 | 1700074 | ||||||
Davita # 191 Honesdale Dialysis Center | Maple Avenue- Route 6 - Sturbridge Mall | Honesdale | PA | 18431 | 0VYXE7B00 | 225512 | ||||||
Davita 3518 Huntingdon Valley | 769 Huntingdon Pike | Huntingdon Valley | PA | 19006 | 77H83BH00 | 286078 | ||||||
Davita -6162 Johnstown At Home | 344 Budfield Street | Johnstown | PA | 15904 | FG0XDKP00 | 1405266 | ||||||
Davita Johnstown | 344 Budfield Street | Johnstown | PA | 15904 | C3NMG8C00 | 285823 | ||||||
Davita - Pdi Lancaster At Home | 1412 East King Street | Lancaster | PA | 17602 | 63JDNC400 | 1283076 | ||||||
Davita Pdi Lancaster | 1412 East King Street | Lancaster | PA | 17602 | J5AK6QE00 | 230985 | ||||||
Davita Pdi Lancaster Pd #1917 | 2110 Harrisburg Pike Suite 310 | Lancaster | PA | 17601 | G15TEMF00 | 1275480 | ||||||
Dialysis Center At Oxford Court | 930 Town Center Drive, Suite G. 100 | Langhorne | PA | 19047 | 4EY6JCH00 | 275809 | ||||||
Davita Dialysis | 611 Electric Ave | Lewistown | PA | 17044 | ER2K8A900 | 230061 | ||||||
Davita 3557 McKeesport West | 101 9th Avenue | McKeesport | PA | 15132 | 418PWYW00 | 320581 | ||||||
Davita Meadville Dialysis #4215 | 19050 Park Avenue Plaza | Meadville | PA | 16335 | GMRPRX600 | 209748 | ||||||
Davita - Riddle Dialysis | 100 Granite Drive, Suite 106 | Media | PA | 19063 | 1F8D7CK00 | 1259658 | ||||||
Davita Delaware Valley Dialysis | 102 Davita Dr | Milford | PA | 18337 | 6DAN3FY00 | 230708 | ||||||
Davita Monroeville Dialysis #4335 | 2690 Monroeville Blvd | Monroeville | PA | 15146 | 10PBVXT00 | 1483818 | ||||||
Davita Thorn Run Dialysis #5503 | 1136 Thorn Run Rd Ste J1 | Moon Township | PA | 15108 | GKC7V8M00 | 1705289 | ||||||
Davita 3045 Waverly-Fka Lansdowne | 407 Baltimore Pike | Morton | PA | 19070 | L9FLX6X00 | 209782 | ||||||
Davita 3013 Northumberland Dialysis | 103 West State, Route 61 | Mount Carmel | PA | 17851 | 4MYQFC500 | 232044 |
Page 45 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita #5504 | 1620 Pacific Ave | Natrona Heights | PA | 15065 | 16HLAVE00 | 1720799 | ||||||
Davita Dialysis Center At St. Mary | 60 Blacksmith Rd | Newtown | PA | 18940 | 20F9A5500 | 232647 | ||||||
Old Forge Dialysis | 325 S. Main St. | Old Forge | PA | 18518 | 35TE0Q500 | 346876 | ||||||
Davita Palmerton | 185 Delaware Avenue, Suite C | Palmerton | PA | 18071 | 8408XCT00,HH0CE1P00 | 225939 | ||||||
Davita 4065 Paris | 32 Steubenville Pike | Paris | PA | 15021 | 84JRQT500 | 229645 | ||||||
Davita #1657 Pdi Walnut Towers | 834 Walnut St. Ste 100 | Philadelphia | PA | 19107 | 3R44GEW00 | 286039 | ||||||
Davita - Callowhill Dialysis Center | 313 Callowhill St. | Philadelphia | PA | 19123 | 8J09TLE00 | 1448545 | ||||||
Davita - West Dialysis Center | 7609 Lindbergh Blvd | Philadelphia | PA | 19153 | D480WAV00 | 1409971 | ||||||
Davita 2361 Broad Street Dialysis Center | 1172-74 S. Broad St. | Philadelphia | PA | 19146 | E5DP8WP00 | 1472948 | ||||||
Davita 3042 Roxborough | 5003 Umbria St. | Philadelphia | PA | 19128 | 669WFKG00 | 209769 | ||||||
Davita 3295 Philadelphia Pmc | 51 North 39th Street | Philadelphia | PA | 19104 | GHHW05F00 | 209747 | ||||||
Davita 3472 Philadelphia 42nd Street | 4126 Walnut St. | Philadelphia | PA | 19104 | 23BRJG600 | 213468 | ||||||
Davita 3675 Market Street | 3701 Market St. | Philadelphia | PA | 19104 | 21QXF1600,E579CMX00 | 1172784 | ||||||
Davita 4211 Cobbs Creek Dialysis | 1700 S. 60th St. | Philadelphia | PA | 19142 | 3BP5DG100 | 209749 | ||||||
Davita 42nd Street At Home Clinic #6271 | 4126 Walnut Street | Philadelphia | PA | 19104 | 2823Y7K00 | 1272833 | ||||||
Davita Cottman Dialysis #5038 | 7198 Castor Ave | Philadelphia | PA | 19149 | KF49JHC00 | 1720930 | ||||||
Davita Dialysis 1070-2 At Magee Rehabilitation Hospital-Acute | 1513 Race St. Floor 3 | Philadelphia | PA | 19102 | 9KFR3VX00 | 1464179 | ||||||
Davita Franklin At Home # 6003 | 301 Callowhill St. | Philadelphia | PA | 19123 | 31T2Q1Q00 | 1100225 | ||||||
Davita Franklin At Home Pa#5021 | 301 Callowhill St. | Philadelphia | PA | 19123 | 8J9L8MF00 | 1647729 | ||||||
Davita Franklin Dialysis Center | 150 South Independence,West 101 Public Ledger Building | Philadelphia | PA | 19106 | 48GFN4Y00 | 209754 | ||||||
South Philadelphia Dialysis Center | 109 Dickinson Street | Philadelphia | PA | 19147 | T8AWR6400 | 224113 | ||||||
Total Renal Care - Northeast Philadelphia | 518 Knorr Street | Philadelphia | PA | 19111 | 5RC70CR00 | 224112 | ||||||
Davita - Pittsburgh At Home | 4312 Penn Avenue | Pittsburgh | PA | 15224 | 03E51E100 | 1405114 | ||||||
Davita 2509 Pittsburgh | 4312 Penn Ave | Pittsburgh | PA | 15224 | 2503YCK00 | 319904 | ||||||
Davita 3676-2 Health South Harmarville Dialysis Center-Acute | 320 Guys Run Rd | Pittsburgh | PA | 15238 | 2KJLTDW00 | 1463580 | ||||||
Davita 3676-3 Kindred Healthcare-Northshore Dialysis-Acute | 1004 Arch St. | Pittsburgh | PA | 15212 | 52XY91C00 | 1463393 | ||||||
Davita 4060 Jefferson | 14 Clairton Blvd | Pittsburgh | PA | 15236 | R0LK7Z200 | 221137 | ||||||
Davita 4336 East End Dialysis Center | 7714 Penn Ave | Pittsburgh | PA | 15221 | JG27QYW00 | 1432796 | ||||||
Davita Bloomfield Dialysis | 5171 Liberty Ave | Pittsburgh | PA | 15224 | A4RCDJD00 | 1453818 | ||||||
Davita Home Dialysis Modality Center of Excellence | 5171 Liberty Ave | Pittsburgh | PA | 15224 | KG6T77D00 | 1468184 | ||||||
Davita Northside Dialysis #5506 | 320 E. North Ave | Pittsburgh | PA | 15212 | 9K1F49M00 | 1715531 | ||||||
Davita 3473 Radnor | 250 King of Prussia Rd | Radnor | PA | 19087 | 74R4QJF00 | 235572 | ||||||
Davita Radnor At Home | 250 King of Prussia Road | Radnor | PA | 19087 | K9CTVC500 | 1409897 | ||||||
Davita Scranton Dialysis | 475 Morgan Highway | Scranton | PA | 18508 | D3VLJM100 | 346880 | ||||||
Davita - Selinsgrove Clinic | 1030 North Susquehanna Trail | Selinsgrove | PA | 17870 | B0LKTR000 | 235443 | ||||||
Davita Sellinsgrove At Home | 1030 N. Susquehanna Trl | Selinsgrove | PA | 17870 | BC7WVDY00 | 1435955 | ||||||
Davita Sellersville Dialysis #5558 | 1112 Old Bethlehem Pike | Sellersville | PA | 18960 | 62P040100 | 233471 | ||||||
Davita Somerset County Dialysis #5507 | 229 S. Kimberly Ave Suite 100 | Somerset | PA | 15501 | J6NNG2H00 | 1715528 | ||||||
Physicians Dialysis of Lancaster, LLC - Pdi Ephrata | 67 West Church Street | Stevens | PA | 17578 | F0TF95100 | 281217 | ||||||
Mount Pocono Dialysis Center - #1504 | 100 Community Drive, Suite 106 | Tobyhanna | PA | 18466 | 88QB6M900 | 346096 | ||||||
Davita Tunkhannock Dialysis | 880 State Route 6 West | Tunkhannock | PA | 18657 | 864CD7E00 | 346878 | ||||||
Renal Treatment Center - Upland | 1 Medical Boulevard, Professional Office Building Ii, Suite 120 | Upland | PA | 19013 | TWU1N6D00 | 209776 | ||||||
Davita Franklin Commons Dialysis Center #5037 | 720 Johnsville Blvd Ste 800 | Warminster | PA | 18974 | 3DWCR6L00 | 1660871 | ||||||
Renal Care of Warren, LLC | 2 W. Crescent Park | Warren | PA | 16365 | L5413XV00 | 281768 | ||||||
Davita #5586 Oak Springs | 764 Locust Ave | Washington | PA | 15301 | HFPG7PX00 | 278181 | ||||||
Davita 4223 Waynesburg | 248 Elm Drive | Waynesburg | PA | 15370 | 81Q4Q2V00 | 235929 | ||||||
Davita # 860 Jennersville Dialysis | 1011 West Baltimore Pike, Suite 107 | West Grove | PA | 19390 | FLD37AX00 | 235809 | ||||||
Davita 4028 Homestead | 207 West 7th Avenue | West Homestead | PA | 15120 | L8629DN00 | 280826 | ||||||
Davita 4034 McKeesport | Oak Park Mall, 2001 Lincoln Way | White Oak | PA | 15131 | 2D48Y7W00 | 209753 | ||||||
Davita 3016 Abington | 3940 Commerce Ave Ste A | Willow Grove | PA | 19090 | 7JV15G700 | 232528 | ||||||
Davita Abbeville Dialysis Center #4397 | 904 W. Greenwood St. | Abbeville | SC | 29620 | J2TLWMH00 | 1697062 | ||||||
Davita 3078 Aiken | 775 Medical Park Dr | Aiken | SC | 29801 | 765E4FF00 | 209695 | ||||||
Davita 3952 Central Bamberg Dialysis | 67 Sunset Dr | Bamberg | SC | 29003 | O26JAPE00 | 209003 | ||||||
Davita Palmetto Dialysis #5573 | 317 Professional Park Road | Clinton | SC | 29325 | 82BKJQE00 | 285679 | ||||||
Ara Columbia Kidney Center | 3511 Medical Dr | Columbia | SC | 29203 | 14Q0VF500 | 209678 | ||||||
Ara Columbia Northeast Dialysis | 10 Gateway Corners Park Ste 200 | Columbia | SC | 29203 | KJYEKFE00 | 320623 | ||||||
Davita - Capitol Centre Dialysis Center #2312 | 201 Columbia Mall Blvd Ste 141 | Columbia | SC | 29223 | F0TFLJR00 | 1454696 | ||||||
Davita - Central Columbia At Home | 3511 Medical Drive | Columbia | SC | 29203 | DK61VNM00 | 1283099 | ||||||
Davita 3914 Allendale | 202 Hampton Ave N. | Fairfax | SC | 29827 | EHRBQPC00 | 231114 | ||||||
Davita Fort Mill | 1975 Carolina Place Drive | Fort Mill | SC | 29708 | HH5WBDN00 | 1220925 | ||||||
Davita Fountain Inn Dialysis #5576 | 298 Chapman Rd | Fountain Inn | SC | 29644 | C5Y43M800 | 1285290 | ||||||
Charleston Renal Care Goose Creek | 109 Greenland Dr | Goose Creek | SC | 29445 | 73240P500 | 1100241 | ||||||
Davita Greenville West End Dialysis #5575 | 605 South Academy Street | Greenville | SC | 29601 | AHF0R8500 | 235974 | ||||||
Davita Upstate At Home Clinic #6159 | 308 Mills Avenue | Greenville | SC | 29605 | FAGAG0V00 | 1272835 | ||||||
Upstate Dialysis Center, Inc. | 308 Mills Ave | Greenville | SC | 29605 | 574SF4R00 | 213496 | ||||||
Davita 3931 Greenwood | 109 Overland Dr | Greenwood | SC | 29646 | EEGAM1500 | 209692 | ||||||
Davita # 0383 | 211 Village Dr | Greer | SC | 29651 | J379Z8900 | 213498 | ||||||
Davita Greer South Dialysis #5574 | 3254 Brushy Creek Rd | Greer | SC | 29650 | 24X99M700 | 1207761 | ||||||
Davita 3935 Lancaster County | 980 N. Woodland Dr Ste 100 | Lancaster | SC | 29720 | JLO04MI00 | 222028 | ||||||
Davita 2336 Longs Dialysis Center | 90 Cloverleaf Dr Unit 306 | Longs | SC | 29568 | 677Q8TB00 | 1458132 | ||||||
Davita | 3919 Mayfair St. | Myrtle Beach | SC | 29577 | 4EM97BV00 | 1200024 | ||||||
Charleston Renal Care Faber Place | 3801 Faber Place Drive | North Charleston | SC | 29405 | ACRYRBD00 | 1137970 | ||||||
Davita #1758 Dialysis | 5900 Rivers Ave Unit E. | North Charleston | SC | 29406 | 2FM62GR00 | 308050 | ||||||
Davita 3916 Orangeburg | 3031 St. Matthews Road | Orangeburg | SC | 29118 | MXVHOFY00 | 209699 | ||||||
Davita 3917 Orangeburg South | 1080 Summers Ave | Orangeburg | SC | 29115 | K8HT0VX00 | 233152 | ||||||
Davita 3632 Pageland | 505-A South Pearl Street | Pageland | SC | 29728 | DL40J1M00 | 346909 | ||||||
Davita Pendleton Dialysis Center #2087 | 7703 Highway 76 | Pendleton | SC | 29670 | LA3EKA600 | 1116054 | ||||||
Davita 2440 Ridgeland Dialysis Center | 112 Weatherbee St. | Ridgeland | SC | 29936 | 70F8Q1L00 | 1454211 | ||||||
Davita 3901 Santee | 228 Bradford Blvd | Santee | SC | 29142 | A1WP2DB00 | 219533 | ||||||
Davita 2335 Jedburg Dialysis Center | 2897 W. 5th North St. | Summerville | SC | 29483 | 35MYYVL00 | 1428931 | ||||||
Davita 3073 Walterboro | 302 Ruby St. | Walterboro | SC | 29488 | AL3FR9D00 | 209679 | ||||||
Davita #0240 Mitchell Community Dialysis | 525 North Foster | Mitchell | SD | 57301 | 89QE53T00 | 230900 | ||||||
Rosebud Dialysis of Davita | 1 Soldier Creek Road | Rosebud | SD | 57570 | 0DK4T5Z00 | 216796 | ||||||
Davita Sioux Falls | 800 E. 21st St. Suite 4600 | Sioux Falls | SD | 57105 | 63HWQ1D00 | 229739 | ||||||
Davita Bolivar Dialysis | 515 Pecan Drive | Bolivar | TN | 38008 | E3N9V5D00 | 234839 | ||||||
Davita Brownsville Dialysis | 380 Dupree Rd | Brownsville | TN | 38012 | E82EDGV00 | 233848 | ||||||
Davita Dialysis #2043 | 168 W. Main St. Ste A | Camden | TN | 38320 | FCVY25R00 | 275078 | ||||||
Davita 3019 Clarksville | 231 Hillcrest Dr | Clarksville | TN | 37043 | 9ULO5K100 | 213510 | ||||||
Davita-Clarksville North | 3071 Clay Lewis Road | Clarksville | TN | 37040 | EGJKE5G00 | 1285196 | ||||||
Davita Collierville Dialysis | 791 West Poplur, Suite 102 | Collierville | TN | 38017 | 259AG8E00 | 318988 | ||||||
Davita 3432 Columbia | 1705 Grove Dr | Columbia | TN | 38401 | 8KD8IVQ00 | 209619 | ||||||
Davita 2914 Cookeville | 140 West 7th Street | Cookeville | TN | 38501 | GPONY2G00 | 209651 | ||||||
Davita Cookeville At Home | 140 W. 7th Street | Cookeville | TN | 38501 | J5RBHJQ00 | 1279414 | ||||||
Davita #5013 Wolf River | 7990 Trinity Rd | Cordova | TN | 38018 | JC2VF5C00 | 1715517 | ||||||
Davita 3539 Tipton County | 107 Tennessee Ave | Covington | TN | 38019 | C9328DB00 | 234838 | ||||||
Davita 3540 Dyersburg | 1575 Parr Ave | Dyersburg | TN | 38024 | D1524VK00 | 209631 | ||||||
Davita 3438 Franklin | 3983 Carothers Pkwy Suite E4 | Franklin | TN | 37067 | K1446HG00 | 228589 | ||||||
Davita Sumner | 300 Steamplant Road, Suite 270 | Gallatin | TN | 37066 | L09172400 | 213516 | ||||||
Davita Humboldt Dialysis | 2214 Osborne St. | Humboldt | TN | 38343 | G9CAE1Q00 | 234834 | ||||||
Davita Carriage House Dialysis | 37 Carriage House Dr | Jackson | TN | 38305 | G9MKXXP00 | 209615 | ||||||
Davita Stonegate Dialysis | 23 Sandstone Circle | Jackson | TN | 38305 | 0JMH7E700 | 233847 | ||||||
Davita Tennessee Valley | 107 Woodlawn Drive, Suite 2 | Johnson City | TN | 37604 | B3KLQHQ00 | 1249617 | ||||||
Davita 4307 Knoxville Dialysis Central Dialysis Center | 9141 Cross Park Dr Ste 102 | Knoxville | TN | 37923 | 20BW34G00 | 1289070 | ||||||
Davita Knoxville Central At Home #5967 | 9141 Cross Park Dr Ste 102 | Knoxville | TN | 37923 | 33L5G4G00 | 1478835 | ||||||
Davita At Galleria | 9160 Highway 64 Ste 10 | Lakeland | TN | 38002 | CK9A9G400 | 275729 | ||||||
Davita Memphis Galleria Dialysis Hhd/Pd #4308 | 9045 Highway 64 Ste 102 | Lakeland | TN | 38002 | 7DGVWVM00 | 1453922 | ||||||
Davita 3434 Lawrenceburg | 2022 North Locust Avenue | Lawrenceburg | TN | 38464 | 9607M8G00 | 275862 | ||||||
Davita Lexington Dialysis | 317 West Church | Lexington | TN | 38351 | 05MA00100 | 277661 | ||||||
Davita Livingston Dialysis | 308 Oak Street | Livingston | TN | 38570 | EFEC5NB00 | 1266287 | ||||||
Davita 3437 Cumberland | 312 Hospital Drive, Suite 5 | Madison | TN | 37115 | 5LXVHCB00 | 275953 | ||||||
Davita #2432 Memphis Downtown Dialysis Center | 2076 Union Ave | Memphis | TN | 38104 | 65MQLQY00 | 1454084 |
Page 46 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita #4387 State Line | 2049 E. Shelby Dr | Memphis | TN | 38116 | F1JWG8J00 | 1728571 | ||||||
Davita 2521 Memphis South | 1205 Marlin Rd | Memphis | TN | 38116 | EB3YHQX00 | 319707 | ||||||
Davita 3017 Memphis Central Dialysis | 889 Linden Ave | Memphis | TN | 38126 | 04FYV4G00 | 221188 | ||||||
Davita 3018 Memphis East Humphreys | 50 Humphreys Ctr Ste 42 | Memphis | TN | 38120 | YU85WAB00,YU85WABF1 | 224087 | ||||||
Davita Capelville Dialysis Center #4357 | 7008 E. Shelby Dr | Memphis | TN | 38125 | EF2DH4T00 | 1627348 | ||||||
Davita Memphis Downtown Pd/At Home Dialysis # 1988 | 2076 Union Ave Floor 2 | Memphis | TN | 38104 | 017P58A00 | 1467819 | ||||||
Davita Memphis East Dialysis Pd #3891 | 50 Humphreys Ctr Ste 28b | Memphis | TN | 38120 | G0VMHCQ00 | 1468232 | ||||||
Davita Memphis Midtown Dialysis Center #4394 | 3430 Summer Ave | Memphis | TN | 38122 | 19J55AD00 | 1647711 | ||||||
Davita Memphis Southeast Dialysis Center | 1805 Moriah Woods, Suite 101 | Memphis | TN | 38117 | HJ2KVXE00 | 1404604 | ||||||
East Memphis At Home # 6041 | 50 Humphreys Ctr Ste 42 | Memphis | TN | 38120 | 01YWAKP00,FLVKG8300 | 1199852 | ||||||
Davita Millington Dialysis Center #4428 | 8510 Wilkinsonville Rd Ste 121 | Millington | TN | 38053 | 70ETHFA00 | 1612832 | ||||||
Davita 3433 Murfreesboro | 1346 Dow St. | Murfreesboro | TN | 37130 | ISQUZ0T00 | 209616 | ||||||
Davita 3431 Whitebridge Road | 103 White Bridge Rd | Nashville | TN | 37209 | 47E791600 | 209625 | ||||||
Davita Home Training and Pd Dialysis #S 6321 and 3892 | 1919 Charlotte Ave Ste 200 | Nashville | TN | 37203 | K01HA7J00 | 1479365 | ||||||
Davita-Nashville Home Training Dialysis # 6054 | 103 White Bridge Pike Ste 6 | Nashville | TN | 37209 | 7800WX800 | 232402 | ||||||
Davita Ripley Dialysis Center #2446 | 854 Highway 51 S. | Ripley | TN | 38063 | K1PTA0D00 | 1683024 | ||||||
Davita Pickwick #1709 | 121 North Pickwick Street | Savannah | TN | 38372 | JFJFKN300 | 281218 | ||||||
Davita Selmer Dialysis | 251 Oak Grove Road | Selmer | TN | 38375 | H9QVXW400 | 231821 | ||||||
Davita Dialysis Smyrna | 537 Stonecrest Parkway | Smyrna | TN | 37167 | 8BEDQ7700 | 1266202 | ||||||
Davita 2385 Somerivlle Dialysis Center | 12475 Us Highway 64 | Somerville | TN | 38068 | 1C5DL3J00 | 1454212 | ||||||
Davita Sparta Dialysis Center #5007 | 150 Sam Walton Dr Suite 800 | Sparta | TN | 38583 | AFNCJ4B00 | 1692349 | ||||||
Davita #4474 | 795 Hamra St. | Tiptonville | TN | 38079 | 8JN9RXB00 | 1647795 | ||||||
Davita Arlington Dialysis Center #2153 | 1250 E. Pioneer Pkwy Ste 700 | Arlington | TX | 76010 | 6H3JAAT00 | 1169937 | ||||||
Davita - El Milagro At Home | 2800 South Interstate Highway #35, Suite 120 | Austin | TX | 78704 | T21ER7800 | 1252548 | ||||||
Davita South Austin Dialysis Center | 6114 South 1st Street | Austin | TX | 78745 | BH1Q42P00 | 1112432 | ||||||
Davita Waterloo Dialysis Center | 5310 Burnet Rd Ste 122 | Austin | TX | 78756 | 3FKKKPV00,59E4J6L00 | 221360 | ||||||
El Milagro Dialysis Center | 2800 S. I. Hwy 35-Ste 120 | Austin | TX | 78704 | BBWNXRT00 | 230911 | ||||||
Moncrief Dialysis Center | 800 West 34th Street | Austin | TX | 78705 | L3FYVPL00 | 235774 | ||||||
Davita Baytown Dialysis # 4437 | 4665 Garth Rd Suite 900 | Baytown | TX | 77521 | 158VMMH00 | 1617405 | ||||||
Total Renal Care - Bedford Dba: Heb Dialysis Center | 1401 Brown Trl Ste A | Bedford | TX | 76022 | U031FXA00 | 209507 | ||||||
Davita - Beeville | 100 West Huntington Street | Beeville | TX | 78102 | 45E6XE400 | 1232737 | ||||||
Davita S. Ft Worth Dialysis # 2220 | 6260 Southwest Blvd | Benbrook | TX | 76109 | 435CM0A00 | 1720759 | ||||||
Davita- Boerne Dialysis | 1369 South Main Street, Suite 101 | Boerne | TX | 78006 | C2KM06Q00 | 1398221 | ||||||
Davita Bonham Dialysis Center #2125 | 201 West 5th Street | Bonham | TX | 75418 | C7GXHYB00 | 1166561 | ||||||
Davita 3249 Brenham | 2536 South Day Street | Brenham | TX | 77833 | T4NUY4G00 | 217155 | ||||||
Davita Carrollton Dialysis Center #2209 | 1544 Valwood Parkway, Suite 114 | Carrollton | TX | 75006 | K9HG96500 | 1219465 | ||||||
Davita - Cedar Park Dialysis | 1720 E. Whitestone Blvd. | Cedar Park | TX | 78613 | 95V11EP00 | 1405147 | ||||||
Davita Cedar Park At Home Dialysis | 1720 E. Whitestone Blvd | Cedar Park | TX | 78613 | E741Y3R00 | 1409155 | ||||||
Davita 3006 Channelview | 777 Sheldon, Suite C | Channelview | TX | 77530 | 61TQ42W00 | 222709 | ||||||
Davita #0919 Cleveland Dialysis Center | 600 East Houston Street, Suite 630 | Cleveland | TX | 77327 | T4QTY8M00 | 231977 | ||||||
Davita 3248 Bryan College Station | 701 University Dr E. Ste 401 | College Station | TX | 77840 | 56FXPAM00 | 209535 | ||||||
Davita 3670 Rock Prairie Road | 1605 Rock Prairie Road, Suite 101 | College Station | TX | 77845 | L6WXDB800 | 1125867 | ||||||
Da Vita - Conroe Dialysis | 500 Medical Center Blvd Ste 175 | Conroe | TX | 77304 | KYF5YNN00 | 230157 | ||||||
Davita River Park Dialysis Center #2078 | 2010 S. Loop 336 W. Ste 220 | Conroe | TX | 77304 | 13B5D6300 | 1108348 | ||||||
Davita Oso Bay #2219 | 7502 S. Padre Island Dr | Corpus Christi | TX | 78412 | J783WDA00 | 1647829 | ||||||
Davita Oso Bay At Home #5941 | 7502 S. Padre Island Dr | Corpus Christi | TX | 78412 | D4H8LLC00 | 1647830 | ||||||
Davita - Cuero Lakeview Kidney Center | 1105 E. Broadway St. | Cuero | TX | 77954 | B7Y5GFG00 | 1110248 | ||||||
Davita #2474 Central Dallas Dialysis Center | 9500 N. Central Expy Suite 102 | Dallas | TX | 75231 | C73T32K00 | 1463774 | ||||||
Davita - Lake Cliff Dialysis #2239 | 805 North Beckley Avenue | Dallas | TX | 75203 | 76AECDQ00 | 1285414 | ||||||
Davita - Oak Cliff Dialysis Center #421 | 2000 South Llewelin Avenue | Dallas | TX | 75224 | 6LQGXD700 | 1112548 | ||||||
Davita 3455 Dallas East-Utshs Jv | 3312 N. Buckner Blvd Ste 213 | Dallas | TX | 75228 | 196FD8G00 | 282267 | ||||||
Davita Brookriver At Home | 8101 Brookriver Dr | Dallas | TX | 75247 | DBRV4P300 | 1269394 | ||||||
Davita Dallas North #2039 | 11886 Greenville Avenue, Suite 100b | Dallas | TX | 75243 | AL1LT0A00 | 1088764 | ||||||
Davita Ut Southwestern Oakcliff Dialysis Center | 610 Wynnewood Dr | Dallas | TX | 75224 | EKJY3TB00 | 223255 | ||||||
Dialysis Specialists of Dallas, Dba: Elmbrook Kidney Center | 7920 Elmbrook, Suite 108 | Dallas | TX | 75247 | DMKX2K200 | 230041 | ||||||
Dowtown Dallas Dialysis | 3515 Swiss Avenue, Suite A | Dallas | TX | 75204 | A9GRLR200 | 1246356 | ||||||
Ut Southwestern Dallas Dialysis | 8230 Elmbrook Dr | Dallas | TX | 75247 | 3462EKD00,5IM8XJX00 | 232290 | ||||||
Davita - Denison At Home | 1220 Reba Mcentire Lane | Denison | TX | 75020 | EHNW7J400 | 1283238 | ||||||
Davita - Denison Dialysis Center | 1220 Reba Macentire Lane | Denison | TX | 75020 | DWGJ8Q600 | 226421 | ||||||
Davita 4337 Duncanville Dialysis Center | 270 E. Highway 67 Ste 100 | Duncanville | TX | 75137 | G7NQ4GK00 | 1463601 | ||||||
Davita Edna Dialysis Center #2202 | 1008 N. Wells St. | Edna | TX | 77957 | KE90VLN00 | 1219143 | ||||||
Ceilo Vista Dialysis | 7200 Gateway Blvd E. Ste B. | El Paso | TX | 79915 | T34WA6C00 | 229685 | ||||||
Central City Dialysis Center | 1300 Murchison Dr Ste 320 | El Paso | TX | 79902 | F75A0AB00 | 224329 | ||||||
Davita | 7933 North Mesa | El Paso | TX | 79932 | HAF3A7Q00 | 1193404 | ||||||
Davita - Americas Dialysis # 5012 | 715 N. Americas Ave | El Paso | TX | 79907 | 7JTEQ3Q00 | 1701072 | ||||||
Davita East | 11989 Pellicano Drive | El Paso | TX | 79936 | EBPCEAE00 | 1224164 | ||||||
Davita Sun City Dialysis Center #2056 | 600 Newman Street | El Paso | TX | 79902 | 80APRLJ00 | 1125430 | ||||||
Davita Transmountain Dialysis Center #2088 | 5255 Woodrow Bean Transmountain Dr | El Paso | TX | 79924 | J2J54AN00 | 1117162 | ||||||
Mission Hills Dialysis | 2700 N. Stanton St. | El Paso | TX | 79902 | B580BYX00 | 345241 | ||||||
Total Renal Care - Loma Vista | 1382 Lomaland Dr Ste A | El Paso | TX | 79935 | 973FF3G00 | 232653 | ||||||
Total Renal Care - Mesa Vista Dialysis Facility | 2400 N. Oregon St. Ste C | El Paso | TX | 79902 | 8FL5CK900 | 233800 | ||||||
West Texas Dialysis | 1250 E. Cliff Dr Bldg B. | El Paso | TX | 79902 | 94W55K300 | 231261 | ||||||
Davita 3028 Floresville | 543 10th St. | Floresville | TX | 78114 | 2CC6M1J00 | 231800 | ||||||
Davita 3479 Island Dialysis | 5920 Broadway St. | Galveston | TX | 77551 | EGT49PP00 | 209558 | ||||||
Davita Garland Dialysis Center | 776 East Centerville Road | Garland | TX | 75041 | 2306CAX00 | 1233142 | ||||||
Davita Gilmer Dialysis Center | 519 North Wood Street | Gilmer | TX | 75644 | C9APE5300 | 1116005 | ||||||
Davita # 0927 | 1406 North Sara Dewitt | Gonzales | TX | 78629 | L0KH3XM00 | 233257 | ||||||
Davita Grapevine Dialysis Center #2154 | 1600 West Northwest Highway, Suite 100 | Grapevine | TX | 76051 | 16765PE00 | 1169935 | ||||||
Grapevine At Home #6020 | 1600 West Northwest Highway, Suite 100 | Grapevine | TX | 76051 | GH6K1YM00 | 1203187 | ||||||
Davita Hearne Dialysis Center # 2438 | 106 Cedar St. | Hearne | TX | 77859 | EDAHMTX00 | 1468400 | ||||||
Davita Henderson Dialysis Center | 1002 Highway 79 North | Henderson | TX | 75652 | A2PJ4XL00 | 278534 | ||||||
Cyfair Dialysis Center | 9110 Jones Rd Ste 110 | Houston | TX | 77065 | J19B35C00 | 234651 | ||||||
Davita # 247 Memorial Dialysis | 11621 Katy Freeway | Houston | TX | 77079 | 8ELMBPT00 | 234653 | ||||||
Davita #0930 North Houston Dialysis | 129 Little York Rd | Houston | TX | 77076 | YP36YE800 | 228544 | ||||||
Davita #2420 Tc Jester Dialysis | 1800 W. 26th St. Ste 101 | Houston | TX | 77008 | 19JA4KR00 | 1624059 | ||||||
Davita - Central | 610 South Wayside Drive, Suite B. | Houston | TX | 77011 | 2GXJPD000 | 228673 | ||||||
Davita - Houston Kidney Center - Cypress Station | 221 Fm 1960 Road West | Houston | TX | 77090 | L1KNGMV00 | 231194 | ||||||
Davita - Jancinto At Home Dialysis #6176 | 11515 Market Street Rd | Houston | TX | 77029 | 2K0GRB400 | 1495273 | ||||||
Davita - Lonestar Dialysis Center | 8560 Monroe Rd | Houston | TX | 77061 | GH9C2H100 | 228704 | ||||||
Davita - Omni | 9350 Kirby, Suite 110 | Houston | TX | 77054 | 0H4YHAA00 | 226735 | ||||||
Davita 3007 Sagemont | 10851 Scarsdale Blvd Ste 200 | Houston | TX | 77089 | 7VLUHHF00 | 222214 | ||||||
Davita 3008 San Jacinto | 11430 I. 10 East Freeway, Suite 330 | Houston | TX | 77029 | TM952C700 | 222208 | ||||||
Davita 3049 Houston | 7543 South Fwy | Houston | TX | 77021 | FTCW0DT00 | 209506 | ||||||
Davita 3057 Reliant | 1335 La Concha Lane | Houston | TX | 77054 | JNHV8LBF0 | 314923 | ||||||
Davita 3064 North Loop East | 7139 North Loop East | Houston | TX | 77028 | 057PG0H00 | 230087 | ||||||
Davita 6013 Med Center At Home | 7580 Fannin St. Ste 230 | Houston | TX | 77054 | 3KYLVMN00 | 1422743 | ||||||
Davita Bayou City Dialysis Center #2121 | 10655 Eastex Freeway | Houston | TX | 77093 | L6VTWGR00 | 1172356 | ||||||
Davita Bear Creek Dialysis Center | 4978 North Highway 6, Suite 1 | Houston | TX | 77084 | HHX98W800 | 1215620 | ||||||
Davita Binz #4453 | 1213 Hermann Dr Ste 180 | Houston | TX | 77004 | 1CLGMJJ00 | 1623912 | ||||||
Davita Binz Hhd/Pd #5945 | 1213 Hermann Dr Ste 180 | Houston | TX | 77004 | 15H9F3E00 | 1623913 | ||||||
Davita Brookhollow Dialysis Center #2027 | 4918 W. 34th St. | Houston | TX | 77092 | A0XXBVA00 | 1065353 | ||||||
Davita Champions Dialysis Center #4436 | 4427 Fm 1960rd W. Ste D | Houston | TX | 77068 | 99986LQ00 | 1653461 | ||||||
Davita Dialysis | 5610 Almeda Road | Houston | TX | 77004 | 47CBQWK00 | 209518 | ||||||
Davita Downtown Houston Dialysis Center #2045 | 2207 Crawford Street | Houston | TX | 77002 | 556EN8P00 | 1116044 | ||||||
Davita Houston | 1335 La Concha Ln | Houston | TX | 77054 | JNHV8LB00 | 230082 | ||||||
Davita Jacinto Dialysis Center #2047 | 11515 Market Street Rd | Houston | TX | 77029 | F1QPCMT00 | 1115853 | ||||||
Davita Med-Center At Home #6013 | 5610 Almeda Drive | Houston | TX | 77004 | AGCDBD300 | 1192891 | ||||||
Davita Northstar Dialysis Center | 380 West Little York Rd | Houston | TX | 77076 | 8L116GH00 | 228191 | ||||||
Davita Sage Meadow Dialysis #4495 | 10923 Scarsdale Blvd | Houston | TX | 77089 | FFFHW9V00 | 1624750 | ||||||
Davita Spring Branch Dialysis Center #1593 | 1425 Blalock, Suite 100 | Houston | TX | 77055 | 02093KY00 | 231421 | ||||||
Davita West Oaks Dialysis #4442 | 14800 Westheimer Rd Suite A | Houston | TX | 77082 | KFRKFPE00 | 1715391 |
Page 47 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita Willowbrook Dialysis Center #2101 | 12120 Jones Road, Suite G. | Houston | TX | 77070 | EA73R8X00 | 1177500 | ||||||
Davita-Cypress Woods Dialysis Center #2472 | 20320 Northwest Fwy Ste 100 | Houston | TX | 77065 | 5K6C0DK00 | 1473136 | ||||||
Houston Kidney Center Southwest | 11111 Brooklet Drive, Building 100, Suite 100 | Houston | TX | 77099 | 2AJV8CA00 | 261006 | ||||||
Northwest Kidney Center, Llp | 11029 Northwest Freeway | Houston | TX | 77092 | G9H68K400 | 219028 | ||||||
Physician Dialysis Inc. - South Houston | 5989 South Loop East, Southport Business Park | Houston | TX | 77033 | JGNRFF700 | 1088816 | ||||||
Physicians Dialysis, Inc. - North Houston | 7115 North Loop East, Northport #2 | Houston | TX | 77028 | GCPK2BE00 | 1077144 | ||||||
Spring Dialysis | 607 Timberdale Lane, Suite 100 | Houston | TX | 77090 | 03J400Q00 | 276125 | ||||||
Summit Dialysis Center #2089 | 3150 Polk Street | Houston | TX | 77003 | 3E0LWMK00 | 1177424 | ||||||
Davita Deerbrooke Dialysis | 9660 Fm 1960 Bypass Rd W. | Humble | TX | 77338 | 20DXKPL00 | 1207084 | ||||||
Davita 3250 Huntsville | 521 Interstate Highway 45 Ste 20 | Huntsville | TX | 77340 | BE0E48F00 | 226948 | ||||||
Davita - Mid-Cities At Home | 125 East Harwood Road, Suite 117 | Hurst | TX | 76054 | 0CPPHGN00,97CY3RK00 | 1285096 | ||||||
Davita - Mid-Cities Dialysis Center | 117 East Harwood Road | Hurst | TX | 76054 | HFF6FPL00 | 1285095 | ||||||
Davita #0240 Katy Dialysis Center | 403 W. Grand Pkwy S. Suite T. | Katy | TX | 77494 | FLQACP100 | 234652 | ||||||
Davita Katy Cinco Ranch #3065 | 1265 Rock Canyon Dr | Katy | TX | 77450 | 2HTFQ4L00 | 1279416 | ||||||
Davita Katy Grand Parkway Dialysis #0246 | 403 W. Grand Pkwy S. Suite T. | Katy | TX | 77494 | 0D159LD00 | 288613 | ||||||
Davita Pin Oak Dialysis | 1302 Pin Oak Road | Katy | TX | 77494 | G31469300 | 319642 | ||||||
Davita Kaufman Dialysis Center # 4309 | 2851 Millennium Dr | Kaufman | TX | 75142 | HBG1W9E00 | 1491959 | ||||||
Davita #3027 | 515 Granda Pl | Kerrville | TX | 78028 | 8J2AEL200 | 209537 | ||||||
Davita - Kerrville At Home | 515 Granada Pl, Suite A | Kerrville | TX | 78028 | F47N8F000 | 1289216 | ||||||
Kilgore Dialysis Center #2068 | 209 Highway 42 North | Kilgore | TX | 75662 | F715YC200 | 1080302 | ||||||
Total Renal Care - Kingwood | 2300 Green Oak Dr Ste 500 | Kingwood | TX | 77339 | W156FM900 | 221633 | ||||||
Davita 3478 Mainland Dialysis | 2600 Gulf Fwy | La Marque | TX | 77568 | SYQGE0A00 | 213822 | ||||||
Davita Lancater Dialysis Center #2156 | 2424 W. Pleasant Run Rd | Lancaster | TX | 75146 | 0LXRV0400 | 1169933 | ||||||
Davita Meridian Dialysis Center #2098 | 201 West Fairmont Parkway, Suite A | Laporte | TX | 77571 | G83B15800 | 1138354 | ||||||
Davita South Shore Dialysis Center #2116 | 212 Gulf Freeway, Suite G-3 | League City | TX | 77573 | 0H4MX3700 | 1141823 | ||||||
Davita Live Oak Dialysis # 914 | 6700 Randolph Blvd Suite 101 | Live Oak | TX | 78233 | 456VBYJ00 | 209520 | ||||||
Davita- Livingston Dialysis Center | 209 West Park Drive | Livingston | TX | 77351 | WWM4A3V00 | 227684 | ||||||
Davita Longview | 425 N. Fredonia St. Ste 300 | Longview | TX | 75601 | 040FBA400 | 232816 | ||||||
Davita Longview At Home | 425 North Fredonia | Longview | TX | 75601 | A3PEV8J00 | 1246424 | ||||||
Fourth Street Dialysis | 3101b North 4th Street | Longview | TX | 75605 | 8CXKM7U00 | 209524 | ||||||
Davita Lufkin At Home Dialysis | 700 S. John Redditt Dr | Lufkin | TX | 75904 | 2B04Q8F00 | 1453929 | ||||||
Davita Lufkin Dialysis | 700 South John Redditt Drive | Lufkin | TX | 75904 | 3C3D1D900 | 216368 | ||||||
Davita Magnolia Dialysis | 17649 Fm 1488 Rd | Magnolia | TX | 77354 | 2DMF83R00 | 1435990 | ||||||
Davita Mansfield Dialysis Center | 987 North Walnut Creek Drive, Suite 101 | Mansfield | TX | 76063 | K9F08HX00 | 1249818 | ||||||
Davita - Marshall Dialysis | 1301 South Washington | Marshall | TX | 75670 | NHNKIE700 | 213471 | ||||||
Davita - Pinecrest Dialysis Center #2083 | 913 East Pinecrest Drive | Marshall | TX | 75670 | 91DMX1700 | 1112554 | ||||||
Davita #2387 | 1203 St. Claire Blvd Ste 9b | Mission | TX | 78572 | 0726LJJ00 | 1647646 | ||||||
Davita - New Braunfels Dialysis | 900 Loop 337 Rd | New Braunfels | TX | 78130 | CCPWEK700 | 278852 | ||||||
Davita- North Hills Dialysis | 7927 Blvd 26 | North Richland Hills | TX | 76180 | 2B0NYNL00 | 1405415 | ||||||
Davita # 0477 Pearland Dialysis | 6516 Broadway St. Ste 122 | Pearland | TX | 77581 | ACAMR2B00 | 319171 | ||||||
Davita 3029 Pearsall | 1305 N. Oak St. | Pearsall | TX | 78061 | GLA4VCM00 | 232541 | ||||||
Davita 2267 Plano Dialysis | 481 Shiloh Rd | Plano | TX | 75074 | 09ACMXE00 | 1454172 | ||||||
Davita Plano At Home #5942 | 481 Shilo Rd Ste 100 | Plano | TX | 75074 | GFTWM7D00 | 1647751 | ||||||
Davita West Plano Dialysis Center #4412 | 5036 Tennyson Pkwy | Plano | TX | 75024 | C5E4KYH00 | 1488253 | ||||||
Davita - Port Lavaca Dialysis #1913 | 1300 N. Virginia St. Ste 102 | Port Lavaca | TX | 77979 | 1KPGVPA00 | 1458233 | ||||||
Davita Rockport Dialysis Center # 2413 | 2102 Fm2165 | Rockport | TX | 78382 | A73MERB00 | 1468233 | ||||||
Davita Rockwall | 2455 Ridge Rd Ste 101 | Rockwall | TX | 75087 | F4WPR0V00 | 1431189 | ||||||
Davita -Southwest San Antonio Dialysis | 7515 Barlite Blvd | San Antonio | TX | 78224 | DQB8ZI300 | 209519 | ||||||
Davita 3048 San Antonio | 4151 Callaghan Rd Ste 101 | San Antonio | TX | 78228 | I34Y82X00 | 209503 | ||||||
Davita 3062 San Antonio Southwest | 1620 Somerset Rd | San Antonio | TX | 78211 | KKQT6G900 | 213481 | ||||||
Davita Downtown San Antonio | 615 East Quincy | San Antonio | TX | 78215 | 52GAXVP00 | 1229595 | ||||||
Davita Floyd Curl Dialysis # 4433 | 9238 Floyd Curl Dr Ste 102 | San Antonio | TX | 78240 | CC95MWK00 | 1497143 | ||||||
Davita Las Palmas Dialysis Center #2194 | 803 Castroville Road, #415 | San Antonio | TX | 78237 | 97WG8XX00 | 1166426 | ||||||
Davita Marymont Dialysis Center #2191 | 2391 North East Loop 410, Suite 211 | San Antonio | TX | 78217 | 49XFX7T00,BAKDV4H00 | 1166217 | ||||||
Davita Northwest Medical Center Dialysis #2192 | 5284 Medical Drive, Suite 100 | San Antonio | TX | 78229 | F7H52GQ00 | 1166218 | ||||||
Davita Rivercenter Dialysis Center #2190 | 1123 North Main Street, Suite 150 | San Antonio | TX | 78212 | 23FQWAG00,AC8ET3400 | 1166220 | ||||||
Davita San Antonio At Home | 5284 Medical Drive, Suite 100 | San Antonio | TX | 78229 | C8RB10N00 | 1229583 | ||||||
Davita South San Antonio Dialysis | 1313 Southeast Military Drive, Suite 111 | San Antonio | TX | 78214 | 5G2AP7T00 | 233532 | ||||||
Davita Southcross Dialysis Center #2193 | 4602 East Southcross Boulevard | San Antonio | TX | 78222 | HB1RPNW00 | 1166221 | ||||||
Davita Southwest San Antonio Dialysis | 7515 Barlite Boulevard | San Antonio | TX | 78224 | DL5E6L800 | 1269842 | ||||||
Total Renal Care-Northwest San Antonio | 8132 Fredericksburg Road | San Antonio | TX | 78229 | 6W5BXT800 | 213484 | ||||||
Davita Hill Country Dialysis | 1820 Peter Garza Street | San Marcos | TX | 78666 | L6LYTHK00 | 235688 | ||||||
Davita 2339 Sealy Dialysis Center | 2242 Championship Dr | Sealy | TX | 77474 | 54N7L1P00 | 1463394 | ||||||
Davita 6215 Woodlands At Home Dialysis | 9301 Pinecroft Dr Ste 130 | Shenandoah | TX | 77380 | K6F8J0W00 | 1453977 | ||||||
Davita # 0923 Sherman Dialysis Center | 205 West Lamberth Road | Sherman | TX | 75092 | 2BX6HFC00 | 234667 | ||||||
Davita - First Colony Dialysis. | 1447 Highway 6 Ste 140 | Sugar Land | TX | 77478 | ED3P46T00 | 1405272 | ||||||
Davita Taylor Dialysis Center # 2437 | 3100 W. 2nd | Taylor | TX | 76574 | 6K6DJJB00 | 1483819 | ||||||
Davita #0932 Tomball | 27720 State Pkwy | Tomball | TX | 77375 | 77JA41C00 | 233084 | ||||||
Davita - Victoria Dialysis | 1405 Victoria Station Drive | Victoria | TX | 77901 | G58NLBC00 | 209523 | ||||||
Davita - Woodlands Dialysis Center | 9301 Pinecroft Drive, Suite 130 | Woodlands | TX | 77380 | 698N57M00 | 1285206 | ||||||
Davita- Lone Peak Dialysis Center | 1175 East 50 South, Suite 111 | American Fork | UT | 84003 | 98AVGLN00 | 1400591 | ||||||
Davita Weber Valley At Home #5966 Dialysis | 1920 W. 250th N. | Ogden | UT | 84404 | 9FD6KLC00 | 1473178 | ||||||
Davita Weber Valley Dialysis | 1920 W. 250th N. | Ogden | UT | 84404 | 20HEV6Y00 | 1449206 | ||||||
Davita Utah Valley Dialysis | 1055 North 500 West, Suite 221 | Provo | UT | 84604 | 1EAKE6T00,64BJK1P00 | 217182 | ||||||
Davita Utah Valley Dialysis At Home #6014 | 1055 North 500 West, Suite 221 | Provo | UT | 84604 | 5L07KEV00 | 1275623 | ||||||
Davita Wasatch Acute Dialysis | 1055 North 500 West, Suite 222 | Provo | UT | 84604 | 65R715F00 | 278786 | ||||||
Davita Bountiful Dialysis | 724 West 500 South, Suite 300 | West Bountiful | UT | 84087 | A0EJT9900 | 275902 | ||||||
Davita West Bountiful Dialysis At Home | 724 West 500 South, Suite 300 | West Bountiful | UT | 84087 | K97GPQV00 | 1098006 | ||||||
Continental Dialysis Center - Alexandria | 5999 Stevenson Avenue, Suite 100 | Alexandria | VA | 22304 | SU8K86S00 | 219952 | ||||||
Davita 3273 Alexandria | 5150 Duke St. | Alexandria | VA | 22304 | DB3KQDE00 | 261178 | ||||||
Davita Franconia Dialysis Center #2040 | 5695 King Centre Drive, 1st Floor | Alexandria | VA | 22315 | E2T5GMG00 | 1050694 | ||||||
Davita 3708 Amelia Dialysis | 15151 Patrick Henry Highway | Amelia | VA | 23002 | 136X1LT00 | 233511 | ||||||
Davita- Amelia At Home | 15151 Patrick Henry Highway | Amelia | VA | 23002 | K0DCFE200 | 1282923 | ||||||
Davita 3757 Arlington | 1701 North George Mason Drive | Arlington | VA | 22205 | HD9DAA000 | 213830 | ||||||
Davita - Charlottesville North | 1800 Timberwood Boulevard | Charlottesville | VA | 22911 | J938T1X00 | 1211478 | ||||||
Davita 3272 Charlottesville | 1460 Pantops Mountain Pl | Charlottesville | VA | 22911 | C851K7H00,EFFJ40V00 | 220642 | ||||||
Davita N. Charlottesville At Home | 1800 Timberwood Boulevard, Suite C | Charlottesville | VA | 22911 | 245FHX400 | 1272557 | ||||||
Davita #0908 Chesapeake | 1400 Crossways Boulevard, Crossways Ii, Suite 106 | Chesapeake | VA | 23320 | K9M32BV00 | 228659 | ||||||
Davita-Great Bridge Dialysis - Total Renal Care | 745 Battlefield Blvd N. Ste 100 | Chesapeake | VA | 23320 | 9BV6HVX00 | 281058 | ||||||
Davita 3715 Chester | 10360 Iron Bridge Road, Chesterfield Meadows West | Chester | VA | 23831 | C7C3DT400 | 282179 | ||||||
Davita 3762 Covington | 2504 Valley Ridge Rd | Covington | VA | 24426 | QABVIL900 | 209438 | ||||||
Davita 3763 Culpepper | 430 Southridge Pkwy | Culpeper | VA | 22701 | H7BGHC800 | 213501 | ||||||
Meherrin Dialysis Center, Inc. | 201-A Weaver Avenue | Emporia | VA | 23847 | 33WG8RH00,VVN3JWV00 | 213504 | ||||||
Davita Fairfax At Home | 8501 Arlington Blvd Ste 100 | Fairfax | VA | 22031 | 15BLDYD00 | 1448593 | ||||||
Davita of Fairfax | 8501 Arlington Boulevard, Suite 100 | Fairfax | VA | 22031 | K464FLY00 | 274973 | ||||||
Fair Oaks Dialysis Center | 3955 Pender Drive, One Pender Business Park | Fairfax | VA | 22030 | FL2AA0M00 | 1088705 | ||||||
Front Royal Dialysis Center | 1077 D Shenandoah Avenue | Front Royal | VA | 22630 | 5CM3JXM00 | 227442 | ||||||
Davita Haymarket Dialysis #2268 | 14664 Gap Way | Gainesville | VA | 20155 | CKP57DA00 | 1269936 | ||||||
Davita Butler Farm At Home | 501 Butler Farms Rd. | Hampton | VA | 23666 | HKQ8PMA00 | 1409898 | ||||||
Davita- Butler Farm #2421 | 501 Butler Farm | Hampton | VA | 23666 | 8CNXXLM00 | 1283035 | ||||||
Davita - Harrisonburh At Home | 871 Cantrell Ave.,Suite 100 | Harrisonburg | VA | 22801 | FE2Y3D900 | 1405101 | ||||||
Davita 3765 Harrisonburg | 871 Cantrell Ave Ste 100 | Harrisonburg | VA | 22801 | DV0T2HK00 | 209449 | ||||||
Davita - Hopewell Dialysis | 301 West Broadway | Hopewell | VA | 23860 | A4JW81200 | 220649 | ||||||
Davita 4395 Leesburg Dialysis Center | 224d Cornwall St. Nw Suite 100 | Leesburg | VA | 20176 | 20X3XBA00 | 1454077 | ||||||
Davita 3766 Lexington | 756 North Lee Highway | Lexington | VA | 24450 | 718JELY00 | 213506 | ||||||
Davita - Manassas | 10655 Lamond Drive, Suite 101 | Manassas | VA | 20109 | KL15P2200 | 208880 | ||||||
Davita 4058 Martinsville | 33 Bridge Street, Suite A | Martinsville | VA | 24112 | ELMBFQ100 | 215659 | ||||||
Davita 3482 Mechanicsville | 8191 Atlee Rd | Mechanicsville | VA | 23116 | 2BA3ENR00 | 282156 | ||||||
Davita 3463 Midlothian | 14281 Midlothian Turnpike, Building B. | Midlothian | VA | 23113 | J9R693100 | 284912 | ||||||
Davita Charter Colony Dialysis Center | 2312 Colony Crossing Place | Midlothian | VA | 23112 | 7AMRQRB00 | 1279402 | ||||||
Davita - Peninsula Dialysis Center #1545 | 716 Denbigh Blvd, Suite D1 | Newport News | VA | 23608 | HF0PY1K00 | 346776 |
Page 48 of 54
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | ||||||
Davita Jefferson Avenue Dialysis #4440 | 11234 Jefferson Ave | Newport News | VA | 23601 | EBHAGVR00 | 1694846 | ||||||
Davita Newport News Dialysis | 711 79th Street | Newport News | VA | 23605 | 53Q6GEY00 | 228667 | ||||||
Davita #2150 | 2201 Colonial Ave | Norfolk | VA | 23517 | D8JKAXV00 | 1458987 | ||||||
Davita Leigh Kempsville Dialysis Center | 420 North Center Drive, Suite 128, Building 11 | Norfolk | VA | 23502 | LED2EXP00 | 1157256 | ||||||
Norfolk Dialysis Center - A Total Renal Care Facility | 962 Norfolk Square | Norfolk | VA | 23502 | 95QJ9A600 | 228591 | ||||||
Appomattox Dialysis Center | 15 West Old Street | Petersburg | VA | 23803 | 4FRLFX700 | 276615 | ||||||
Davita - Greater Portsmouth Dialysis Center #1544 | 3516 Queen Street | Portsmouth | VA | 23707 | HHWYGV300 | 346773 | ||||||
Davita - Portsmouth Dialysis Center #2014 | 2000 High Street | Portsmouth | VA | 23704 | DCRQJXM00 | 346346 | ||||||
Davita Purcellville At Home | 280 Hatcher Avenue | Purcellville | VA | 20132 | K450REY00 | 1275454 | ||||||
Purcellville Dialysis Center of Total Renal Care | 280 North Hatcher Avenue | Purcellville | VA | 20132 | 91WD8C300 | 277642 | ||||||
Davita 3609 Radford | 600 East Main Street, Suite F. | Radford | VA | 24141 | D440N7F00 | 346775 | ||||||
Davita Radford At Home | 600 East Main Street, Suite F. | Radford | VA | 24141 | B33MLNB00 | 1405173 | ||||||
Reston Dialysis Center #2059 | 1875 Campus Commons Drive,Suite 110 | Reston | VA | 20191 | DD302KF00 | 1050671 | ||||||
Davita 3417 Richmond Westwood | 5270 Chamberlayne Rd | Richmond | VA | 23227 | 46WKYK800 | 278790 | ||||||
Davita Hioaks #3733 | 671 Hioaks Rd Ste A | Richmond | VA | 23225 | Y3A5GVR00 | 213532 | ||||||
Davita Hioaks Pd #3735 | 681 Hioaks Rd Ste B. | Richmond | VA | 23225 | GKWXQM500 | 1220838 | ||||||
Davita Three Chopt Rd #3732 | 8813 Three Chopt Rd | Richmond | VA | 23229 | 15BH1DC00,AF5MPZ400 | 213521 | ||||||
East End Dialysis Center of Total Renal Care, Inc. | 2201 East Main Street, Suite 100 | Richmond | VA | 23223 | XBBHN6T00 | 209426 | ||||||
Total Renal Care At Richmond Community | 1510 North 28th Street, Suite 110 | Richmond | VA | 23223 | 37RXYNJ00 | 279028 | ||||||
Continental Dialysis Center - Springfield Trc | 8350a Traford Lane | Springfield | VA | 22152 | OKZEHFH00 | 209425 | ||||||
Davita Garrisonville | 70 Doc Stone Road, Suite 101 | Stafford | VA | 22556 | 879KBH000 | 1223499 | ||||||
Davita 3761 Staunton Dialysis | 29 Idlewood Blvd | Staunton | VA | 24401 | 3WF601L00 | 209432 | ||||||
Davita #0684 Sterling Dialysis Center | 46396 Benedict Drive, Suite 100 | Sterling | VA | 20164 | 1379DWT00 | 208878 | ||||||
Davita Harbor View Dialysis Center #2069 | 1039 Champions Way | Suffolk | VA | 23435 | 0C758NJ00 | 1608968 | ||||||
Davita 3701 Tysons Corner | 8391 Old Courthouse Road, Suite 160 | Vienna | VA | 22182 | F64W65W00 | 230539 | ||||||
Davita Tyson’s Corner At Home | 8391 Old Courthouse Road, Suite 160 | Vienna | VA | 22182 | K13JN9300 | 1220456 | ||||||
Davita #0909 Virginia Beach | 740 Independence Cir | Virginia Beach | VA | 23455 | 4M6QC5300 | 229218 | ||||||
Davita At Home - First Colonial #6017 | 1157 First Colonial Road, Suite 200 | Virginia Beach | VA | 23454 | 07KGAJ000 | 1218566 | ||||||
Davita Camelot Dialysis | 1800 Camelot Dr Ste 100 | Virginia Beach | VA | 23454 | 00YQ6E800 | 209442 | ||||||
Davita First Landing Dialysis Center | 1745 Camelot Drive, Suite 100 | Virginia Beach | VA | 23454 | AKYH91J00 | 314821 | ||||||
Davita Williamsburg At Home | 500 Sentara Circle, Ste 103. | Williamsburg | VA | 23188 | J7YK61F00 | 1409992 | ||||||
Davita Williamsburg Dialysis Center | 500 Sentara Cir Ste 103 | Williamsburg | VA | 23188 | G2FKT5F00 | 1275929 | ||||||
Davita #1770 Winchester | 2301 Valor Dr | Winchester | VA | 22601 | FJQXM3A00 | 209437 | ||||||
Davita - Dbacontinental Dialysis Center - Woodbridge Dialysis | 2751 Killarney Drive | Woodbridge | VA | 22192 | L7T3TVC00 | 209439 | ||||||
Davita #2060 - Bellevue Dialysis Center | 3535 Factoria Boulevard South East, Suite 150 | Bellevue | WA | 98006 | 6KKG7QN00 | 1088829 | ||||||
Davita Washington Acutes Dialysis | 3535 Factoria Blvd Se Ste 150 | Bellevue | WA | 98006 | KK0D72Q00 | 1272774 | ||||||
Davita Mill Creek Dialysis Center # 4317 | 18001 Bothell Everett Hwy Ste 112 | Bothell | WA | 98012 | K0MCRGP00 | 1608970 | ||||||
Davita 2368 Ellensburg Dialysis | 2101 W. Dolarway Rd Suite 1 | Ellensburg | WA | 98926 | 42HHEWE00 | 1418780 | ||||||
Davita Everett Dialysis Center 4373 | 8130 Evergreen Way Ste C | Everett | WA | 98203 | 584D9HK00 | 1608971 | ||||||
Davita Federal Way Dialysis | 1015 South 348th Street | Federal Way | WA | 98003 | 1EBQ0DT00 | 225777 | ||||||
Davita - Graham Dialysis # 2173 | 10219 196th Street Ct E. Ste C | Graham | WA | 98338 | 9K7P1RH00 | 1473019 | ||||||
Kent Community Dialysis | 21501 84th Avenue South | Kent | WA | 98032 | 9CC28Y500 | 281406 | ||||||
Lakewood Community Dialysis Center | 5919 Lakewood Town Center Boulevard, Suite A | Lakewood | WA | 98499 | 07H0QJX00 | 234551 | ||||||
Davita Sea View Dialysis Center #2470 | 101 18th Ave S. | Long Beach | WA | 98631 | 2CVV3MT00 | 1612627 | ||||||
Davita Whidbey Island Dialysis #4372 | 32650 Sate Rd 20 Bldg E. | Oak Harbor | WA | 98277 | 2DX3C2T00 | 1644529 | ||||||
Davita Olympia At Home Dialysis #5954 | 335 Cooper Point Rd Nw Ste 1 | Olympia | WA | 98502 | 14VNJ7D00 | 1612612 | ||||||
Davita Olympia Dialysis Center # 4316 | 335 Cooper Point Rd Nw | Olympia | WA | 98502 | DC802YX00 | 1479415 | ||||||
Davita - Mid Columbia At Home | 6825 Burden Boulevard, Suite A | Pasco | WA | 99301 | H20DF2D00 | 1220459 | ||||||
Davita Mid-Columbia Kidney Center | 6825 Burden Boulevard, Suite A | Pasco | WA | 99301 | 8FDM4VL00 | 209406 | ||||||
Davita - Puyallup Dialysis #146 | 716-C South Hill Park | Puyallup | WA | 98373 | EERMFXH00 | 314625 | ||||||
Davita # 5924 Chinook Kidney At Home | 1315 Aaron Dr Bldg C1 | Richland | WA | 99352 | 0KYVLGE00 | 1727513 | ||||||
Davita #2402 Chinook Kidney | 1315 Aaron Dr Bldg C1 | Richland | WA | 99352 | 1BNYB2A00 | 1612646 | ||||||
Davita Olympic View At Home | 125 16th Avenue E, 5th Floor | Seattle | WA | 98112 | 1BB379600 | 1272990 | ||||||
Davita Westwood Dialysis Center #551 | 2615 Southwest Trenton Street | Seattle | WA | 98126 | LC5ADD200 | 1121078 | ||||||
Olympic View Dialysis Center | 125 16th Ave E. Csb Fl 5th | Seattle | WA | 98112 | GB4F81J00 | 277259 | ||||||
Westwood At Home #6018 | 2615 Southwest Trenton Street | Seattle | WA | 98126 | 0650AN800,H7KV1X100 | 1208040 | ||||||
Davita Mount Adams Kidney Center | 3220 Picard Pl | Sunnyside | WA | 98944 | 2D9J49K00 | 229029 | ||||||
Davita Tacoma Center #2077 | 3401 South 19th Street | Tacoma | WA | 98405 | AGJ0KQJ00 | 1173974 | ||||||
Union Gap Dialysis Center #2023 | 1236 Ahtanum Ridge Business Park | Union Gap | WA | 98903 | G6509CC00 | 1104637 | ||||||
Davita Vancouver Dialysis | 9120 Ne Vancouver Mall Drive, Suite 160 | Vancouver | WA | 98662 | E7PFQHW00 | 1266336 | ||||||
Davita Yakima Dialysis Center #1539 | 1221 North 16th Avenue | Yakima | WA | 98902 | LJ3R6LP00 | 345294 | ||||||
Davita Dialysis - Amery | 970 Elden Ave | Amery | WI | 54001 | D1AH63E00 | 1448587 | ||||||
Davita- Amery Pd # 1966 Dialysis | 970 Elden Ave | Amery | WI | 54001 | 858EQ1Q00 | 1463654 | ||||||
Davita 3416 Brookfield | 19395 West Capital Drive, Suite 100 | Brookfield | WI | 53045 | 6BD0C2800 | 280550 | ||||||
Davita 3339 Cedarburg | North 54 West 6135 Mill Street | Cedarburg | WI | 53012 | 7F0DD0C00 | 276655 | ||||||
Davita Fox River Dialysis Center At Home | 1910 Riverside Drive | Green Bay | WI | 54301 | 556001H00 | 1256004 | ||||||
Davita Fox River Dialysis Center, #1744 | 1910 Riverside Drive | Green Bay | WI | 54301 | RVQ5GZW00 | 209368 | ||||||
Davita Titletown Dialysis Center, #1745 | 120 Siegler Street | Green Bay | WI | 54303 | JE78MDB00 | 1070627 | ||||||
Davita 3642 Janesville | 1305 Woodman Rd | Janesville | WI | 53545 | 58PT353F1 | 209366 | ||||||
Davita 3070 Loomis Road | 4120 W. Loomis Rd | Milwaukee | WI | 53221 | HRWALML00 | 213519 | ||||||
Davita 3169 Wisconsin Ave | 3801 West Wisconsin Avenue | Milwaukee | WI | 53208 | TYY446300 | 209367 | ||||||
Davita 3171 Rivercenter | 117 N. Jefferson Street | Milwaukee | WI | 53202 | WL9E72D00 | 216316 | ||||||
Davita Bay Shore Dialysis #5566 | 5650 N. Green Bay Ave | Milwaukee | WI | 53209 | LKQAL0Q00 | 346461 | ||||||
Davita Bluemound Dialysis # 5568 | 601 N. 99th St. Ste 100 | Milwaukee | WI | 53226 | DCFNGT000 | 1193258 | ||||||
Davita Humbolt Ridge Dialysis #5564 | 2211 N. Humboldt Blvd | Milwaukee | WI | 53212 | 94CY24T00 | 1413886 | ||||||
Davita South Ridge Dialysis #5567 | 4848 S. 76th St. Ste 100 | Milwaukee | WI | 53220 | 0B95NHT00 | 314837 | ||||||
Davita West Appleton Dialysis #5565 | 10130 W. Appleton Ave | Milwaukee | WI | 53225 | A48DP2Q00,LF7DL3800 | 319345 | ||||||
Davita #2406 Oak Creek Dialysis | 8201 S. Howell Ave Ste 600 | Oak Creek | WI | 53154 | FFFBD1Y00 | 1453978 | ||||||
Davita Northwoods Dialysis Center, #1746 | West 7305 Elm Avenue | Shawano | WI | 54166 | 553GPXF00 | 223413 | ||||||
St. Croix Falls Dialysis - Total Renal Care | 744 Louisiana East | St. Croix Falls | WI | 54024 | EBANG8A00 | 213547 | ||||||
Davita Bluemound At Home # 5939 | 601 N. 99th St. Ste 110 | Wauwatosa | WI | 53226 | 4BPDX0E00 | 1692355 | ||||||
Davita Bluemound Pd #5569 | 601 North 99th Street, Suite 300 | Wauwatosa | WI | 53226 | 5JW4E0200 | 282955 | ||||||
Davita Dialysis #1069 Dba: Pdi Camc Acutes | 501 Morris Street | Charleston | WV | 25301 | 32M1M7L00 | 320446 | ||||||
Davita 3764 Greenbrier | 129 Seneca Trail | Lewisburg | WV | 24901 | 8IE719L00 | 213524 | ||||||
Davita #1582 | 300 Prosperity Ln | Logan | WV | 25601 | 9B9V3JA00 | 281240 | ||||||
Davita Parkersburg #3494 | 1824 Murdoch Avenue, Suite 44 | Parkersburg | WV | 26101 | 625P3Y300 | 285731 |
Page 49 of 54
Exhibit D
Designated Managed Centers
Page 50 of 54
Contract Number |
Member Name | Member Street | Member City | Member State |
Member ZIP |
Member HIN | Member ACIS | |||||||||||||
Managed | 200800239 | Davita Riverside Pd Central | 3660 Park Sierra, Suite 108 | Riverside | CA | 92505 | B5E6Y4200 | 1269332 | ||||||||||||
Managed | 200800239 | Total Renal Care | 111 Michigan Avenue Northwest | Washington | DC | 20010 | 3300208F3 | 236059 | ||||||||||||
Managed | 200800239 | Davita #1912 | 640 Broadway Ste 100 | Macon | GA | 31201 | B2L63CJ00 | 276941 | ||||||||||||
Managed | 200800239 | Maize Dialysis Center | 10001 Grady Avenue | Maize | KS | 67101 | 59K34KP00 | 1276525 | ||||||||||||
Managed | 200800239 | Renal Care of Seat Pleasant | 6274 Central Avenue | Seat Pleasant | MD | 20743 | DFN5LLQ00 | 1093866 | ||||||||||||
Managed | 200800239 | Davita Moses Taylor Hospital Renal Unit # 1715 | 700 Quincy Avenue | Scranton | PA | 18510 | 232670KF2 | 346875 | ||||||||||||
Managed | 200800239 | Davita Aurora Medical Group Dialysis Center # 3330 | 210 Wisconsin American Dr | Fond Du Lac | WI | 54937 | 48LYJBP00 | 275140 | ||||||||||||
Managed | 200800239 | Davita 3607 Aurora Med Grp Brown County | 1751 Deckner Ave | Green Bay | WI | 54302 | B9KXD3H00 | 342100 | ||||||||||||
Managed | 200800239 | Davita 3338 Aurora Med Grp - Lake Geneva | 146 Lake Geneva Square | Lake Geneva | WI | 53147 | 5LCDTHP00 | 284510 | ||||||||||||
Managed | 200800239 | Davita Aurora Medical Group - Manitowoc #3665 | 601 Reed Ave | Manitowoc | WI | 54220 | F4NNV5T00 | 1108513 | ||||||||||||
Managed | 200800239 | Davita 3555 Aurora Med Grp Marinette | 4061 Old Peshtigo Rd | Marinette | WI | 54143 | 1AHCQ3X00 | 344513 | ||||||||||||
Managed | 200800239 | Davita #3653 Oshkosh West | 855 North Westhaven Drive | Ohskosh | WI | 54904 | D05J6Y500 | 1065342 | ||||||||||||
Managed | 200800239 | Davita 3331 Aurora Med Grp - Sheboygan | 2414 Kohler Memorial Dr | Sheboygan | WI | 53081 | 78T1CAV00 | 275346 | ||||||||||||
Managed | 200800239 | Davita 3641 Aurora Med Grp-Sturgeon Bay | 108 South 10th Avenue | Sturgeon Bay | WI | 54235 | 8XQ12YWF1 | 346516 | ||||||||||||
Managed | 200800239 | Davita - Aurora Medical Group Wautoma Dialysis #3672 | 900 E. Division St. | Wautoma | WI | 54982 | 4C07DPP00 | 1134468 |
Page 51 of 54
Schedule 1
Data
1. | Facility ID; |
2. | Patient ID (sufficient to consistently track an individual patient without in any way disclosing the identity of the patient); |
3. | Date of Patient’s [DELETED] (by Patient ID) – refers to the date of [DELETED] with Dialysis Center, its Designated Affiliates or Managed Centers. |
4. | Modality; Including designation of in-center Hemodialysis (“HD”) ID; peritoneal dialysis (“PD”) ID; or home hemodialysis (“HHD”) ID. A patient shall be defined as receiving HD, PD or HHD treatment if that specific modality designation represents the majority of the treatments during a given month or if the patient receives that modality during the last three (3) treatments of the given month. The parties agree and understand that Dialysis Center is not currently able to provide these designations with great accuracy. Dialysis Center shall provide this information to the best of Dialysis Center’s ability in the interim. |
5. | Number of patients with [DELETED] and [DELETED]; |
6. | All [DELETED] with their corresponding draw dates for each patient by Patient ID; |
7. | Each [DELETED] delivered for each patient per treatment with date (Example: [DELETED]); |
8. | [DELETED] for each patient once per calendar month; |
9. | [DELETED] with date; |
10. | [DELETED] with date for each patient; |
11. | [DELETED] with date for each patient; |
12. | [DELETED] and [DELETED] with date for each patient; |
13. | [DELETED] ([DELETED]) with date for each patient; |
14. | [DELETED], [DELETED] or [DELETED] with date – [DELETED]; |
15. | [DELETED]; |
16. | [DELETED]; |
17. | [DELETED]; To the best of Dialysis Center’s knowledge, month, day and year of [DELETED] expressed as mm/dd/yyyy by Patient ID; |
18. | [DELETED]; To the best of Dialysis Center’s knowledge, date of [DELETED] by Patient ID, [DELETED] ([DELETED] and [DELETED] for each [DELETED]) and indicate [DELETED] for each [DELETED]; |
19. | Date of [DELETED] by Patient ID; [DELETED] should not be reflected in this field; |
20. | [DELETED]; |
21. | [DELETED]; |
22. | Hemoglobin Test Results; All hemoglobin test results for each dialysis patient, the date of each such test, a consistent, unique, alpha-numeric case identifier for each patient (sufficient to consistently track an individual patient without in any way disclosing the identity of the patient), and the name, address and phone number of the physical location at which such patient received treatment; and |
23. | [DELETED] of [DELETED] OR [DELETED] - rounded up to [DELETED] (e.g. [DELETED]). |
Page 52 of 54
Schedule 2
Compensation Data
Product Data Submission Requirements. Compensation Data shall be sent in either Excel or a tab-delimited text file to the following email address: salesadj@amgen.com. The file naming convention shall include the Dialysis Center name, Product, and data month and year (i.e. DaVita_Epogen_January_2011). Dialysis Center must supply all of the information set forth in the table below.
ID |
Data Field Name |
Data Field Description | ||
1 | Unique Account Identifier | DaVita’s numeric identifier for each account (PFac & OFac) | ||
2 | Account Name | Account requesting Product | ||
3 | Account Street Address | Account requesting Product | ||
4 | Account City | Account requesting Product | ||
5 | Account State | Account requesting Product | ||
6 | Account zip | Account requesting Product | ||
7 | Dispensing Pharmacy for Product | DaVita’s numeric identifier for location that has dispensed the Product | ||
8 | Product NDC Number | |||
9 | Product Description | Name of Product including strength (Label Name) | ||
10 | Quantity Shipped | |||
11 | Unit Of Measure | Tabs, bottles, vials, etc. | ||
12 | Product shipped/dispensed date |
Page 53 of 54
Schedule 3
Initial Materials
EPOGEN® (Epoetin alfa) Tool and Resource |
Part Number/Job Number | |
Cycle Time Message Card | P301132A / 47103-B | |
OAM Message Cards | P301092C / 44626-B | |
Common Causes of Low Hb | P301040-1C/ 41496-B | |
Patient Interactive Tool | P301146 / 45474-H | |
AMI Insights Presentation Deck * | 48544-C | |
AMI - Cause of Low Hb Deck* | 48903-F-1 | |
AMI Lab Analysis Presentation Deck* | 49134-E |
* | The AMI Programs delivered by the SBRs (EPOGEN® Management in Patients on Dialysis and Managing Low Hemoglobin Levels in Patients on Dialysis Receiving EPOGEN®) are derivatives of the resources listed above considered part of the initial approved material. |
[DELETED] ([DELETED]) Tool and Resource |
Part Number/Job Number | |
2011 [DELETED] Prior Authorization Folder | P501079B | |
Amgen Assist Detail Aid | P501102 | |
Amgen Assist Part D Monograph | P39135-1B | |
Amgen Assist Part D Support Flashcard | P501080A | |
Four Steps to Coverage | P501150-1A | |
[DELETED] Card | P22630-1 | |
DaVita National [DELETED] Card | P501208A | |
Color copy of 2011 [DELETED] visual aid | P22989 | |
[DELETED] patient brochure | P22291B | |
[DELETED] dosing card | P22668B | |
[DELETED] In-Service | ||
[DELETED] Patient brochure | P22951-3 Brochure (w/o holder) | |
[DELETED] Patient DVD | P22956 | |
[DELETED] DVD (P22948) for HCP’s | P22948 | |
[DELETED] educational brochure for HCP’s | P22671 | |
KDOQI Flashcard | P22966 | |
Two-sided OUTCOMES+ Report |
Page 54 of 54