Organization Name: | RENAL THERAPIES LLC |
NPI Number: | 1013029933 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN C BUCHER (CEO) |
Mailing Address: | 410 S. Heinlein Dr. Shelbyville |
State: | IL US |
Postal Code: | 62565 |
Phone Number: | 2177741527 |
Fax Number: | 2177741528 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 10/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 142624 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |