Organization Name: | RENAL CARE GROUP OF THE MIDWEST INC |
NPI Number: | 1104931922 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK R FAWCETT (TREASURER) |
Mailing Address: | 1201 W 12th Ave Emporia |
State: | KS US |
Postal Code: | 668012504 |
Phone Number: | 6203436800 |
Fax Number: | 6203432259 |
NPI Enumeration Date: | 08/20/2006 |
NPI Last Update Date: | 06/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |